Monday June 6th Breakout Sessions 4:00 PM - 5:00 PM
Collaborative Approach to Improving Coding and Documentation on the Neurology Service
Presenters: Rochelle Nichols, Paula Percas, Debra Roberts MD, Sarah Wicks, RN, BSN, MBA; University of Rochester Medical Center
This presentation will detail a collaborative project between providers and coders designed to improve the documentation associated with neurology service inpatient admissions. Working together, we were able to identify frequently missed diagnoses, which allowed for targeted education of providers and the development of note templates to improve documentation. We also identified education topics to help coders better understand the specific disease processes. This collaborative approach led to an increased number of diagnoses per patient and better captured the true severity of illness of our patients.
Hierarchical Condition Categories (HCCs) are used in complex reimbursement formulas by both commercial payers and Medicare Advantage Plans. Submission of HCC data is transitioning from RAPS submissions to encounter based submissions. This has created operational issues for many payers. This presentation will provide an overview of the complexity of HCC methodologies and the issues with RAPS submission versus encounter based submissions. Coders have a role ensuring a complete clinical picture of each member is provided to ensure accurate payment for services provided.
Homecare Auditing for PDGM Compliance and Continuous Process Improvement
Presenter: Amy Lee, RN, RAC-CT, COQS
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