Consulting
New sepsis aftercare code Z51.A: How would you assign to this clinical scenario?
By Joanne Wilson, RN, ADN, CCDS, Senior Director, Solutions We have a new ICD-10-CM code to bill sepsis aftercare. Effective October 1, 2024, coders can report Z51.A: Encounter for Sepsis Aftercare. Z51.A was long in the making, needed to fill a gap in post-sepsis care. Sepsis is nasty and can result in long-term health complications.…
Read MoreOutpatient CDI clinical scenario: What’s your next move?
By Joanne Wilson, RN, ADN, CCDS For this month’s CDI suggestion I wanted to offer up a clinical scenario for your consideration. I do encourage you to read it, and think about what you’d do. My suggestion follows. A patient is scheduled for an appointment with their provider in 96 hours. As a prospective OP…
Read MoreRisk adjustment coding and HEDIS measures: Birds of a feather
Can the work of a CDI specialist or risk adjustment coder impact HEDIS measures? It’s a question growing in importance, as reimbursement is tied to quality outcomes, and transparency and star ratings allow patients to shop for providers and health plans. Some believe HEDIS measures are impacted/satisfied only through the provision of clinical…
Read MoreThe “Risky Business” of Risk Adjustment
Why risk adjustment coders are more valuable than ever By Crystal May, CCS, CPC, CDEO, CPMA, CRC, AAPC Approved Instructor, Senior Risk Adjustment Consultant, Norwood If you’re of a certain age, the title of this article probably conjured up the image of a popular male actor sliding across a wooden floor in a…
Read MoreCoding Tip
Postop respiratory failure: The never-ending query By Donielle Bailey, RHIA, Norwood Senior Auditor We have all experienced the frustration of coding a complex or detailed elective operative report only to become ensnared in a postop progress note respiratory battle. Physicians provide their clinical assessment of the patient’s postop respiratory condition with documentation that includes, “intubated…
Read More