(BOOK)-Risk Adjustment Documentation and Coding

Capturing risk in medical documentation and coding successfully gives a complete and accurate picture of your patients health but it is also critical for ensuring proper reimbursement managing cost projecting future resource requirements and delivering highquality care Chronic diseases are not outliers especially in older patients 80 percent of older adults have at least one chronic condition If you have any Medicare patients with chronic conditions and if you are participating in Meritbased Incentive Payment Systems MIPS the AMAs Risk Adjustment Documentation and Coding 2e RA 2e will help you capture the care rendered so the severity of your patients illnesses is adequately captured to reflect your utilization If you omit riskadjusting diagnoses because a specialist is managing the care of your patients chronic condition you are hurting your MIPS efficiency rating Most chronic conditions will impact the overall health of the patient therefore they are appropriate to capture for your documentationIn a value and outcomebased health care environment lack of specificity in ICD10CM coding and documentation has ripple effects for a practice and its patients like loss of important data and financial returns and increased patient risk Continuity of care and a complete picture of a patients overall health are key to quality care Connecting diagnosis with comorbidities causes with ICD10CM codes such as hypertension with heart disease or diabetes and hyperlipidemia with diabetes etc for patients with chronic conditions helps improve care and documentation RA 2e covers this in detail and can help you document your patients health and wellbeing and help you get the right reimbursement especially for your highrisk patients  Use Risk Adjustment Documentation Coding 2nd Edition to Improve documentation in general and in relation to severity of illness and chronic diseases with risk adjustment parameters Code more accurately with expert guidelines and recommendationsConnect diagnosis with comorbidities cause with the checklists in the teachingtraining tools for the 10 most common chronic diseasesThe impact of riskadjustment coding hierarchical condition category HCC coding on a practice is significant because 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 which disbursed more than 900 million in MIPS bonuses for 2020 is tightening requirements for these bonuses and has also proposed expanding audits on riskadjustment codingFEATURES AND BENEFITSFive chapters delivering an overview of risk adjustment common administrative errors best practices and guidance for development of internal riskadjustment coding policies which are organized by diagnoses topic diabetes dementia ischemic heart etc Each topic has separate guidance for documentation and for coding10 ICD10CM teachingtraining tools for the top10 mostcommon chronic diseases to help with documentation and coding10 ICD10CM coding aid for quick reference and code selection for the top10 mostcommon chronic diseases Two appendices offering mappings and tabular information of ICD10CM codes that riskadjust to CMSHCCs used for MIPS and RxHCCs Learning and design features Vocabulary terms highlighted within the text and defined at the bottom of the page AdviceAlert Notesthat highlight important coding and documentation advice from federal regulatory sources Sidebarsthat provide derivative story and additional information such as Coding Tipsthat guide physicians and coders with practical advice from sources like AHAs Coding Clinic and cautionary notes about conflicts and exceptionsClinical Examplesthat underscore key documentation issues for risk adjustment Clinical Coding Examplesthat provide snippets or full encounter notes and codes to illustrate riskadjustment coding and documentation concepts Documentation tipsthat highlight recommendations to physicians regarding what should be included in the medical record or how ICD10CM may classify specific terms Examplesthat explain difficult concepts and promote understanding of those concepts as they relate to a section FYIcall outs that provide quick facts Abstract Code Itexercises that test diagnosis abstraction and coding skills exclusive to Chapter 4 Assessment tools for instructors and independent learnersExtensive endofchapter Evaluate Your Understanding sections that include multiplechoice questions trueor false questions and audit and Internetbased exercises Two downloadable course tests and slide presentations for each chapter Exclusive content for academic educators A test bank containing 100 questions and a mock riskadjustment certification exam with 150 questions 

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