overall rate of inflation). The Medicare hospital deductible expanded‚ creating a burden for Medicare beneficiaries. 2. How do MS-DRGs encourage inpatient facilities to practice cost management? Linking like patients with like-resource consumption allows hospitals to perform cost management by DRG or DRG groupings. 3. Why was a severity of illness refinement performed on the DRG system? Was it supported by the healthcare community? The severity of illness refinement allows cases with a higher severity
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Revenue Cycle Education Improvement Strategies Presented by: Colleen Malmgren‚ MS‚ RHIA Fairview Health Services cmalmgrl @fairview.org Definition of Revenue Cycle All administrative and clinical functions that contribute to the capture‚ management and collection of patient service revenue *HFMA Scheduling/Registration Health Info Mgmt Case Management Pt Financial Srvcs Charge Capture Revenue Audit Chargemaster Establish Performance Indicators Establish measures that go beyond Accounts receivable
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Clinical documentation improvement (CDI) “...is improving the quality of documentation to help ensure an accurate and complete reflection of the patient’s care‚ comorbid conditions‚ and treatment- which impacts severity of illness (SOI) and risk of mortality (ROM)” (Custodio et al.‚ 2013‚ p. 56 ). This is an important topic for health care facilities and physicians to ensure it is done well so that the quality of care‚ reimbursement and financial aspects are correct. “There are several other factors
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Part II Intermediate Coding Exercises ICD-9-CM Coding Instructions: • Sequence the ICD-9-CM principal diagnosis in the first diagnosis position. • Assign all reportable secondary diagnosis codes including V codes and E codes (both cause of injury and place of occurrence). • Sequence the ICD-9-CM principal procedure code in the first procedure position. • Assign all reportable secondary ICD-9-CM procedure codes. ICD-10-CM and ICD-10-PCS Coding Instructions: • Sequence the ICD-10-CM principal
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Martins Children’s Hospital ------------------------------------------------- Job Detail Inpatient Coding Specialist-MCH HIMS position Job Title Inpatient Coding Specialist - MCH HIMS Job # 12398 Department Name HIMS Coding Hospital MCH Job Type Full Time Schedule
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Question 1 1. According to the OIG‚ the use of copy and paste functions to clone information in EHRs creates: I. Difficulty for coding and billing staff members to tell which activities were competed in the current visit‚ possibly leading to inappropriate charges II. An easy way for unethical providers and/or unethical staff members to use “cloned” information to create fraudulent records or claims. III. A clear picture of services provided during the patient’s stay IV. Accurate and complete documentation
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order to correctly code the reason for the principal diagnosis‚ because it is crucial for the MS-DRG formula. Next the outpatient coding is limited to a stay length of less than 24 hours‚ where as inpatient services are longer due to the intensity of service(s). When it comes to outpatient services‚ physicians are paid using CPT/HCPCS codes. Where as inpatient/hospitals are paid using a complex formula (MS-DRG)‚ because of housing‚ feeding‚ and nursing the patient back to health. During an inpatient
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Procedure|Secondary Procedure|Secondary Procedure|Secondary Procedure| | | | | | | | |DRG:|641 | | | 7 |Principal Diagnosis|Secondary Diagnosis|Secondary Diagnosis|Secondary Diagnosis|Secondary Diagnosis|Secondary Diagnosis| | 528.9|238.71| | | | | ||| | | | | |Principal Procedure|Secondary Procedure|Secondary Procedure|Secondary Procedure|Secondary Procedure|Secondary Procedure| | 24.32|| | | | | |DRG:|159 | | | 8 |Principal Diagnosis|Secondary Diagnosis|Secondary Diagnosis|Secondary
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LTT1 - Healthcare Ecosystems The profession of health informatics is a relatively new one‚ blending the use of technologies with collecting‚ organizing‚ storing‚ using‚ and evaluating health information. Technology can assist healthcare workers on every clinical and administrative level to use information more effectively in clinical decision-making for patients‚ and in implementing strategic goals within an organization. Check Your Understanding 2.1 Instructions: On a separate piece
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Applied Coding--DRG Assignment Name:______ This assignment will be worth 45 points. Part I Instructions (Part I of II): Review the following cases. Select and code the principal diagnosis and all significant secondary diagnoses‚ as well as the principal procedure and secondary procedures as applicable. Use the computer (encoder and grouper) for this assignment. You may use your coding book to locate the codes if you don’t feel comfortable enough with the encoder yet. Once you obtain
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