by Scot Nemchik | Mar 27, 2020 | Clinical Revenue Integrity, Coding
For the most part, updates to code sets and the guidelines that govern their utilization are predictable. Every year, we can bank on changes to the Inpatient Prospective Payment System going into effect on October 1st, and changes to the Outpatient Prospective Payment...
by Scot Nemchik | Aug 15, 2019 | Coding, True Clinical Picture
This blog post is part of our ongoing series discussing the True Clinical Picture. Before we go any further, let’s quickly reflect on what we mean by True Clinical Picture. TRUE CLINICAL PICTURE: A complete and comprehensive record that serves as the source of truth...
by Scot Nemchik | Aug 6, 2019 | Clinical Documentation Improvement, Clinical Revenue Integrity, Coding, Denial Management, True Clinical Picture
For quite some time now CMS has reiterated their plan to perform a comprehensive assessment of current ICD-10-CM complication and comorbidity (CC) and major complication and comorbidity (MCC) designations. This year’s proposed rule, published on April 23, 2019...
by Scot Nemchik | Jul 2, 2018 | Clinical Documentation Improvement, Coding
Over the past few years, CMS has made known their intent to perform a comprehensive CC/MCC analysis to assess the appropriateness of each diagnosis codes ‘CC severity’. CC severity is the term used to describe a codes role as a DRG influencer in the inpatient...
by Scot Nemchik | Mar 5, 2018 | Clinical Revenue Integrity, Coding
Get the DRG and move on. For better or worse, and with rare exception, that was the primary directive governing inpatient coding behavior back when I was coding in the early 2000’s. This edict made sense in context of the limited reach of coded data at the turn of the...
