Help: FAQs, tutorials, videos, page index and more
Viewing:  Sep 21, 2019

Maximizing Resources for ICD-10 Coding Audits

By:  BC Advantage
Published:  March 27th, 2018

From internal reviews to external inpatient coding audits, healthcare organizations nationwide are revisiting tried-and-true audit practices with ICD-10 coding quality in mind. MS-DRG validation audits under ICD-10 have also become more strategic to realize a hospital's revenue cycle success. Coding audit best practices shifted following the implementation of ICD-10. Since all coding stakeholders were comfortable with ICD-9 and needed to maximize budgets, audits were primarily focused on targeted DRGs versus overall coding compliance reviews.

With ICD-10, more frequent audits can help identify the root causes of coding errors before they become ingrained as bad habits. More frequent audits can deliver a positive return on investment, based on assessing coder competency, measuring code quality, and showing how missed errors can have negative effects on an organization’s bottom line. Under ICD-10, coding audits have proven cost savings.

The most common areas for ICD-10 coding errors identified through coding audits include:

  • Not coding to the greatest degree of specificity
  • Missing combination diagnosis codes and linked diagnoses
  • Inaccurately assigning codes for complex cardiac surgeries
  • Misinterpretation of coding guidelines
  • Misidentifying appropriate root operations
  • Incorrect assignment for spinal surgeries

Based on these common errors, a combination of random and focused coding audits has become industry best practice.


Editor's note: Hammerman, director of compliance and education, has more 30 years of leadership experience most recently as the enterprise HIM operations manager for BJC Healthcare. Champagnie, senior director of HIM operations at HIMagine, has 23 years of healthcare business management experience. Opinions expressed are those of the authors and do not represent HCPro or ACDIS. This article originally appeared in HIM Briefings.

The Ohio Health Information Management Association (OHIMA) is Ohio's professional health care organization of 4000 credentialed specialists in the field of health information management (HIM). OHIMA is a non-profit, component state association affiliated with the American Health Information Management Association (AHIMA) and their 103,000 credentialed health information management professionals nationwide.

OHIMA.ORG


References:

###

BC Advantage Logo

Article Tags  (click on a tag to see related articles)



Publish this Article on your Website, Blog or Newsletter

This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active. If you would like to publish this article, please contact us and let us know where you will be publishing it. The easiest way to get the text of the article is to highlight and copy. Or use your browser's "View Source" option to capture the HTML formatted code.

If you would like a specific article written on a medical coding and billing topic, please Contact Us.


Our contact information

Find A Code, LLC
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Fax: 801-770-4428
Email:
Free 14 Day Trial
No Credit Card Required
Pricing
Starting at $10/month
Sign In
Welcome back!