News
Healthcare Organizations (and providers) Liable for Inaccurate Coding, not Technology Vendors. Not fair, but a reality.
By Brian Murphy Who will watch the vendor? Will vendors be held accountable for not just accurate coding, but inaccurate coding and errors and repayment, when machines they manufacture are doing more and more of the work? Tesla has delivered self-driving cars, but these incredibly sophisticated machines are not without fault. In 2019 two pedestrians…
Read MoreNew ICD-10-CM Codes and Guidelines are out, take effect Oct. 1
By Brian Murphy The new ICD-10-CM codes and Official Guidelines are out. I’ve included relevant links below. There are 252 new codes, 36 deleted, and 13 revised codes. These take effect October 1, 2024. Here are some interesting additions, from my non-clinical perspective: Obesity classes added to E66.8 Other obesity. These include the following: E66.811 Obesity,…
Read MoreAudit Provider Documentation to Ensure Accurate Risk Adjustment
Norwood performs CMS compliance-level audits for its partner organizations. These audits involve: Evaluation of provider documentation Review of billed codes Determining whether codes are supported in the documentation Evaluating code accuracy Determining whether a higher (or lower) degree of specificity is warranted Following these steps, we compile the results into a detailed summary of the…
Read MoreOutpatient CDI Specialists (especially with CCDS-O certification) Are in Demand
By Brian Murphy Where are all the CCDS-Os? That’s Certified Clinical Documentation Specialist—Outpatient. Outpatient CDI and risk adjustment are exploding. I know this because our clients are building and expanding their programs, and on the hunt for individuals possessing this rare credential. Of which there’s only a few hundred operating in the wild. You want…
Read MoreStart Your Journey with the Norwood Outpatient CDI Boot Camp
Our campers are all smiles. To learn more or schedule a call contact us at solutions@norwood.com. Download the brochure here. Risk adjustment is a team sport. Accurately depicting the complexity of a broad patient population across your organization requires contributions from patient registration to providers—and everyone in between, including well-trained risk adjustment coding and…
Read MoreSolutions Spotlight: OIG Toolkit a Valuable Blueprint for Risk Adjustment Coding Compliance
By Brian Murphy The OIG Toolkit To Help Decrease Improper Payments in Medicare Advantage Through the Identification of High-Risk Diagnosis Codes is a valuable tool in your compliance arsenal. One you should be using if you’re at all involved with risk adjustment. What is the Toolkit? The toolkit offers Medicare Advantage Organizations (MAO) information that…
Read MoreFive Emerging Mid-Revenue Cycle Roles
By Brian Murphy New job functions will be needed to meet the changing nature of healthcare delivery and reimbursement. And soon. Here are five. These are my predictions but I feel good about them. Note: Many/most of these exist in some form or fashion now, but I believe the demand will grow, and explain why.…
Read MoreHCC Best Practice Advisory (BPA) Alerts a Hot Topic in Compliant Condition Capture
By Jason Jobes, SVP, Norwood Solutions HOT TOPIC QUESTION: Are you using Epic HCC BPAs (or similar tools) and are you worried about their appropriateness or compliance? DISCLOSURE: Norwood does not possess/sell any technology that competes with use of the Epic BPA or currently partner with organizations that have similar functionality. This question is aimed…
Read MoreClean Up Your Problem Lists to Facilitate Accurate Coding
By Brian Murphy Per CMS, a problem list is “a list of current and active diagnoses as well as past diagnoses relevant to the current care of the patient.” But they’re often much more. Physicians use them as a place to think in ink about ongoing and active conditions or store other summarized patient data. …
Read MoreBreaking into CDI as a Foreign Medical Graduate: Eight Strategies for Success
By Brian Murphy Foreign medical graduates (FMG) can make for wonderful CDI professionals—but breaking into the profession poses a unique challenge. Many FMGs emigrate to the U.S. to pursue a career in medicine, but are faced with long odds (30,000 applications for 7000-8000 open residency slots, per one data point I found) and defer that…
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