The ICD-9 Coordination and Maintenance Committee recently posted the March 9-10 Diagnosis Meeting Agenda. The agenda included a discussion of proposed ICD-9 diagnosis additions and revisions as well...Read More »
Recovery Audit Contractors (RAC) denied $86 million in claims in 2010—more than double the $42 million reported in the third quarter. Medically unnecessary services accounted for 57% of the denials, with 33% of these for short stay patients, according to the American Hospital Association’s (AHA...Read More »
Clarifying hospital-acquired conditions (HAC) and present-on-admission (POA) conditions represent just two additional aspects of medical record inspection CDI specialists are frequently asked to perform. Determining whether a condition was actually POA and not a HAC helps coders sequence...Read More »
A patient’s medical record could include a laundry list of diagnoses, but not all of these conditions may be reportable. Coders must determine when they can report conditions as “other” secondary diagnoses and when they must simply leave them off the claim entirely.
Q:I know that in an inpatient setting coders are allowed to use suspected diagnosis when a definitive diagnosis cannot be determined. However, we have had some trouble with physicians using the term “rule out” or “differential diagnosis”...Read More »