BC Advantage - 2018 Issue 3
Maximizing Resources for ICD-10 Coding Audits
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Article Overview
This article discusses how healthcare organizations are updating audit approaches in the ICD-10 environment, with emphasis on internal and external coding review strategies, inpatient audit practices, and MS-DRG validation. It is aimed at coding, compliance, HIM, and revenue cycle professionals who want a high-level understanding of audit focus areas, common error patterns, and why more structured audit programs matter.
Why This Topic Matters
Coding audits help organizations evaluate coding quality, identify recurring error patterns, and support compliance and revenue cycle goals. The article is relevant to teams seeking to understand how ICD-10 has changed audit priorities and why a mix of random and focused reviews can be useful.
Article Sections
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ICD-10 audit strategy and changing priorities
Introduces how audit practices have evolved in the ICD-10 environment and how organizations are approaching coding quality review and validation efforts.
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Common ICD-10 coding audit findings
Summarizes broad categories of coding issues that are frequently identified during audits, including specificity, diagnosis linkage, complex procedures, and guideline interpretation.
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Best-practice audit approach
Describes the general audit approach highlighted in the article and the role of both random and targeted review methods.
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Author and organization information
Provides source attribution and organizational background for the article and its publishers or affiliated professional groups.
What You Will Learn
- How ICD-10 changed the emphasis of coding audits
- Why audit frequency can affect coding quality monitoring
- Which broad categories of coding errors are commonly reviewed
- How audit programs can support compliance and revenue cycle goals
- Why organizations may combine random and focused audits
Who Should Read This
- HIM professionals
- medical coders
- coding auditors
- compliance staff
- revenue cycle teams
- hospital leadership
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