by Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer
May 11th, 2023
This article is about spring cleaning your coding and billing! There are a few concerns coming to light that need tidying up. These include the following:
1. Increasing Denials
Inconsistent documentation will draw denials if the documentation impacts the reimbursement. Some examples include aspiration pneumonia versus pneumonia, unspecified; chronic diastolic congestive heart failure versus acute-on-chronic diastolic congestive heart failure; and sepsis.
Another issue that may draw a denial is when the documentation does not support the payer’s payment policies. Here are examples:
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This article originally published on May 1, 2023 by ICD10monitor.
About Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer
Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays