Chat with us, powered by LiveChat Chapter 2: CodingClass Assignment 101/21/2020. 1.T - Writemia

Chapter 2: CodingClass Assignment 101/21/2020. 1.T

Chapter 2: CodingClass Assignment 101/21/2020. 1.The health information management (HIM) team at Anywhere UniversityHospital (AUH) contracted with an auditing firm to perform fullassessment coding review. The results from this baseline assessment areprovided in four tables:Variation Log by Type of ErrorVariation Log by CoderVariation Log by MS-DRGMS-DRG Relationship AssessmentYouare the inpatient coding manager at AUH. Your director has asked you todevelop an ongoing review and monitoring schedule for the next yearbased on the results from the outside review.Include internal andexternal reviews, coding in-services, physician workshops, and externalseminars/educational sessions that will be performed and or providedfor your staff. The schedule should be specific (include volumes and/orpercentages of charts to be reviewed). Keep in mind that on average ittakes 18 minutes to review one inpatient chart. Budget provides for$15,000 for external reviews. The average cost for reviewing oneinpatient record by an external review team is $55.00 (fully loaded).Inaddition to preparing the schedule, outline how you will maintaincoding quality statistics and report them back to the HIM Director andCompliance Committee at your facility.How will you reward your staff members who show great improvements? How will you reward and/or recognize that your staff has made improvements overall? Your Coding Team consists of: Coding Manager (you) 1 Data Quality Auditor 8 – Inpatient Coders (including Certified Coding Specialists, Registered Health Information technicians and administrators). Results of the full assessment coding review for AUHTwo audits were performed:1. Coding quality review by MS-DRG2. MS-DRG Relationship Analysis Variation Log by Type of Error % of errors Inaccurate sequencing or specificity principal diagnosis, affect MS-DRG 17% Inaccurate sequencing or specificity principal diagnosis, non affect MS-DRG 16% Omission CC, affect MS-DRG 33% Omission CC, non affect MS-DRG 2% Inaccurate principal procedure, affect MS-DRG 3% Omission procedure, affect MS-DRG 4% More specific coding of diagnosis or procedure, non affect MS-DRG 12% Inaccurate coding 5% Missed diagnosis or procedure code 8% Variation Log by Coder Coder Error Rate Standard Coder 1 3% 5% Coder 2 9% 5% Coder 3 8% 5% Coder 4 2% 5% Coder 5 4% 5% Coder 6 16% 5% Coder 7 12% 5% Coder 8 3% 5% Variation Log by MS-DRG* MS-DRG Volume Error Rate 470 420 2% 313 233 14% 392 232 1% 291 232 17% 247 220 3% 292 216 5% 871 213 12% 641 209 0% 194 195 3% 293 193 1% 885 188 3% 312 177 0% 191 175 7% 287 173 2% 310 171 15% 689 157 11% 603 143 2% 379 137 3% 192 131 9% 683 116 11% 189 114 1% 069 110 2% 190 92 12% 193 87 10% 690 76 4% 065 76 5% 195 72 2% 066 52 2% 064 41 5% 906 35 2% *MS-DRG descriptions provided below Variation Log by MS-DRG* Set MS-DRG Set Hospital % Nation % 064 24.3% 21.4% 065 45.0% 43.8% 066 30.8% 34.8% 190 23.1% 15.2% 191 44.0% 33.5% 192 32.9% 51.3% 193 24.6% 17.5% 194 55.1% 54.2% 195 20.3% 28.3% 291 34.6% 29.2% 292 36.7% 38.8% 293 28.8% 31.9% 689 67.4% 21.7% 690 32.6% 78.3% *MS-DRG descriptions provided below MS-DRG MS-DRG Title (FY 2018) 064 Intracranial hemorrhage or cerebral infarction w MCC 065 Intracranial hemorrhage or cerebral infarction w CC 066 Intracranial hemorrhage or cerebral infarction w/o CC/MCC 069 Transient ischemia 189 Pulmonary edema & respiratory failure 190 Chronic obstructive pulmonary disease w MCC 191 Chronic obstructive pulmonary disease w CC 192 Chronic obstructive pulmonary disease w/o CC/MCC 193 Simple pneumonia & pleurisy w MCC 194 Simple pneumonia & pleurisy w CC 195 Simple pneumonia & pleurisy w/o CC/MCC 247 Perc cardiovasc proc w drug-eluting stent w/o MCC 287 Circulatory disorders except AMI, w card cath w/o MCC 291 Heart failure & shock w MCC 292 Heart failure & shock w CC 293 Heart failure & shock w/o CC/MCC 310 Cardiac arrhythmia & conduction disorders w/o CC/MCC 312 Syncope & collapse 313 Chest pain 379 G.I. hemorrhage w/o CC/MCC 392 Esophagitis, gastroent & misc digest disorders w/o MCC 470 Major joint replacement or reattachment of lower extremity w/o MCC 603 Cellulitis w/o MCC 641 Nutritional & misc metabolic disorders w/o MCC 683 Renal failure w CC 689 Kidney & urinary tract infections w/ MCC 690 Kidney & urinary tract infections w/o MCC 871 Septicemia w/o MV 96+ hours w MCC 885 Psychoses 906 Hand procedures for injuries 2.Compare the hospital figures to the state average and the peerfacilities. Why are an individual hospital’s figures above or below thestate average? One potential explanation could be coding or billingerrors. Brainstorm other possible explanations for why a facility’s CMIis higher or lower than the state or its peers? Table 5. Overall CMI—Years 1–3 Facility Year 1 Year 2 Year 3 Hospital A 1.8694 1.9017 2.1473 Hospital B 1.9662 2.0554 2.0267 Hospital C 1.6440 1.6873 1.7010 Hospital D 1.8454 1.7021 1.6250 State Average 1.4480 1.4778 1.4953 3.What is ICD-10? What is ICD-10-CM? Is this classification systemimportant for the future of healthcare reimbursement? Why or why not? Begin your research with the National Center for Health Statistics Web site at: http://www.cdc.gov/nchs/

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