PDF-(EBOOK)-Risk Adjustment Documentation & Coding

Riskadjustment practices consider chronic diseases as predictors of future healthcare needs and expenses Detailed documentation and compliant diagnosis coding are critical for proper risk adjustmentRisk Adjustment Documentation Coding provides Risk adjustment parameters to improve documentation related to severity of illness and chronic diseases Code abstraction designed to improve diagnostic coding accuracy without causing financial harm to the practice or health facility The impact of risk adjustment codingalso called hierarchical condition category HCC codingon a practice should not be underestimated More than 75 million Americans are enrolled in riskadjusted insurance plans This population represents more than 20 of those insured in the United States Insurance risk pools under the Affordable Care Act include risk adjustment CMS has proposed expanding audits on risk adjustment coding Meticulous diagnostic documentation and coding is key to accurate riskadjustment reporting This book will help align the industry though an objective compilation and presentation of risk adjustment documentation and coding issues guidance and federal resourcesFeatures and Benefits Five chapters delivering an overview of risk adjustment common administrative errors best practices topical review of clinical documentation improvement and coding for risk adjustment alphabetized by HCC group and guidance for development of internal risk adjustment coding policies Six appendices offering mappings tabular information and training tools for coders and physicians that include an alphanumeric mapping of ICD10CM codes to HCCs and RxHCCs and information about Health and Human Services HCCs versus Medicare Advantage HCCs Learning and design features Vocabulary terms highlighted within the text and conveniently defined at the bottom of the page AdviceAlert Notes that highlight important advice from the ICD10CM Guidelines for Coding and Reporting Key Coding Concepts that offer the advice published in ICD10CM Coding Clinic for ICD10CM and ICD10PCS Sidebars that detail measurements pertinent to risk adjustment seen in physician documentation eg cancer staging disability status or GFRs Coding Tips that guide coders to the right answers using terminology and ICD10CM Index and Tabular entries or provide cautionary notes about conflicts in the official ICD10CM guidance Clinical Examples that underscore key documentation issues for risk adjustment Clinical coding examples that provide snippets or full encounter notes and codes to illustrate key issues for the HCC or RxHCC Documentation tips highlight recommendations to physicians regarding what should be included in the medical record or how ICD10CM may classify specific terms Examples that explain difficult concepts and promote understanding of those concepts as they relate to a section FYI call outs that provide quick facts Extensive endofchapter Evaluate Your Understanding sections that include multiplechoice questions trueorfalse questions and Internetbased exercises Downloadable slide presentations for each chapter that cover key content and concepts Exclusive content for academic educators A test bank containing 100 questions and a mock riskadjustment certification exam with 150 questions. g gym memberships and exercise classes Medicare Advantage plan receives payment for each member from CMS Payment is based on member predicted health status and demographic characteristics Medicare Advantage plan regulated by CMS brPage 6br Introducti Socioeconomic Status;. Linking Cost and Quality Measures. HSCRC . Performance Measurement . Workgroup. May 28, 2014 . Tom Valuck, MD, JD. Presentation. . Overview. U. pdate . the . Performance Measurement Workgroup . ICD-10 is set to go into effect on October 1st, 2015. Once it does, some of the changes that will go into effect include:. Increasing the number of diagnosis codes from around 13,000 to around 68,000, and the number of procedure codes from 11,000 to 72,000.. Muriel Baldoni, . rhit. Mary Girard, . ba. , ma, . rhit. , ccs-p. Jamey . mcgowen,. . mba. , . rhia. Agenda . Lcd. /. ncd. edits. Staff morale. Computer assisted coding . Simple visit coding. Productivity/. A Work Plan for State Officials. December 2, 2011. Ross Winkelman, FSA Mary Hegemann, FSA and Syed Mehmud, ASA. Contributions by Tom Leonard, James Woolman, Julie . Peper. , and Patrick Holland. Caveats. An Introduction and Discussion. MAPAM. March 16, 2017. Agenda. Risk Adjustment . How Risk Adjustment Works. Risk Adjustment Factor (RAF) Scoring Process. Comprehensive Annual Visits. Predictive Modeling & Quality of Care. Auditing after ICD-10. Background:. I have worked in multiple medical settings from UVA Medical Center to a cancer center. I achieved my RHIA in 2000 and then my . CCS in 2006.. I have worked for Mary Washington Health Care since 2010 and became the Outpatient Coding Compliance Auditor in 2013. . Presented by: . Tracy R. Johnson, CPC. 2015 Mobile Alabama Chapter Vice-President. Objectives:. Introduction on the Importance of Clear Documentation. CPT Coding Audits. Diagnosis Audits. Denial Audits. rhit. Mary Girard, . ba. , ma, . rhit. , ccs-p. Jamey . mcgowen,. . mba. , . rhia. Agenda . Lcd. /. ncd. edits. Staff morale. Computer assisted coding . Simple visit coding. Productivity/. Monitoring remote . Julie Appleton, CCS-P, CPC, CPC-H, FCS, PCS. The materials utilized in this presentation are intended solely for use in conjunction with today’s seminar. . Although great efforts have been taken in the preparation of today’s material, the speakers, nor their employers assume responsibility for errors or omissions or for damages resulting from the use of the information contained therein. . Cynthia Trapp, MS,CHFP, CMPE, CPCO, CPC, CPC-I, AAPC-Fellow, CCS-P, CHC. New England MGMA Regional Conference. Friday May 4, 2018. Defining Risk Adjustment. History of CMS Risk Adjustment. Risk Adjustment Models. Alice B. Torrez MHA, CPC. Educator Coding and Documentation. Health Information Management. University of New Mexico Hospital. 2. View of Risk Adjustment. Are my patients . sicker?. These numbers are not right…. CDI Manager Educator. Erlanger. July 15, 2016. Learning Objectives. At the completion of this educational activity, the learner will be able to:. Provide an overview on structure of ICD-10-CM/PCS coding conventions, guidelines, and official advice essential to understanding Coding Clinic advice. Joann Cassidy RN BSN CCDS. What is this Thing called Outpatient Clinical Documentation Integrity??? . Learning Objectives:. Why the hype about outpatient CDI?. What are HCCs?. How is a risk-adjustment (RAF) score calculated?.