decisionhealth Newsletters, Answer Books - 2009 Issue 7 (July)
Pay for Performance / Hone ICD-9-CM, documentation to get a big jump on P4P
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Article Overview
This article discusses the relationship between ICD-9-CM diagnosis coding, physician documentation, and pay-for-performance reporting programs. It focuses on Medicare quality reporting, the role of quality-measure reporting codes, the importance of documentation in physician records, and operational considerations for claims processing and clearinghouse acceptance. The piece is relevant for physicians, coders, billing staff, and quality-reporting teams working with P4P and PQRI-related workflows.
Why This Topic Matters
Accurate diagnosis coding and documentation can affect whether quality-reporting measures are identified and reported correctly in pay-for-performance environments. The article is useful for practices that want to understand how coding, recordkeeping, and claims workflow support Medicare and private payer quality programs.
What You Will Learn
- How diagnosis coding relates to pay-for-performance reporting
- Why documentation matters in physician quality reporting
- What operational steps practices may take when preparing for quality-measure reporting
- How claims workflow and clearinghouse capabilities can affect reporting submissions
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Quality reporting staff
Codes Discussed
Modifiers Discussed
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