Creating Coding Policies in Risk Adjustment
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Sometimes, coders find that there is no answer in the Guidelines, coding conventions, or AHA's Coding Clinic for ICD-10-CM that answers a question regarding diagnosis coding, and the provider cannot be queried. This session provides practical advice on how to identify when an organization should create a coding policy, how it should be researched, how it should be communicated, and when it should be updated or retired. For example, how should coders abstract ambiguous documentation or confusing acronyms? What is the coder responsibility when the provider uses the words "history of" to identify what is likely a current condition? Identifying, developing and managing internal coding policies consumes resources. How does an organization know when it is worth it? This session won't provide all the answers, but it will provide a roadmap so that organizations can develop answers pertinent to their focus.
Why is this topic important?
This topic is important because coders are often at a loss when the answer isn't readily available through normal citations, and they don't know how to research on their own, or what sources should be believed while researching.
Who would benefit from this topic?
Coders, managers, and quality assurance staff will benefit form this session. While it is geared toward risk adjustment coders, the principles here apply to developing coding policy in any coding environment.
What information or new skills will the attendee take away from this webinar?
Attendees will learn how to prioritize, research, write, train for, maintain, and retire internal coding policies in this session.
Why is the presenter the expert on this topic?
Sheri is the Author of Risk Adjustment Documentation and Coding, published by the AMA. This book has a chapter specific to internal coding policy development.
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