“Industry Changes are Driving Increased Coding and Financial Complexity.”
Every home health agency wants their deserved reimbursement for the care delivered to their patient and just as importantly, they want to retain that revenue. A good start toward achieving that goal is having coding team expertise.
According to one source, the average loss on a miscoded record is hovering around $1200+. The reasons for the errors vary; experience of the coding team, training level, maintaining competency and adherence to coding guidelines and conventions with the hundreds of changes that occur annually and not to mention the over 100,000 changes coming with ICD-10. A coding team needs to be dedicated to just that: coding, not other distracting duties. The team needs coders and clinicians so the full prospective of the patient portrait is accurately presented and the proper codes are compliantly assigned.
With tighter reimbursement, outcomes affecting future reimbursement, and coding driving certain audit alerts, coding is the area that requires emphasis.
Select Data has written a white paper on this subject. Looking at industry complexity and how coding importance came to the forefront to identifying the relationship of case-mix profile and case-mix adjustment models to coding. In addition, understanding the components of the HIPPS Codes as well as how supplies must link to diagnostic codes is included.
Success in this industry usually means the home health leaders have a good understanding of why the change in CMS focus as well as what is expected from that focus. Included in this white paper, you will also find the documentation requirements for coding in general as well as examples of the therapy risk areas. Documentation must be objective and specific. Just what does that mean? Clear examples are presented.
Being alert for “alerts.” Do you know what MAC alert 5023T means? You need this kind of information from your coding team.
The value of compliant coding is proper payment and peace of mind. This is not a trite statement. It is a desire of agency leaders who are working diligently to comply with quality parameters, best practices, and regulatory statutes and law.
To read the full white paper, please go to: Coding Whitepaper PDF