Three Must-take Steps to Minimize Risk
On October 1, 2016, the Centers for Medicare and Medicaid Services (CMS) wrapped up its one-year grace period for allowing the use of unspecified codes without consequence. The governing body also rolled out its first update to the coding system in four years, including a mammoth 6,000 new codes.
Both of these moves could negatively impact financial performance if appropriate action is not taken to minimize risk. Providers still engaging in deficient “unspecified” coding practices face short-term revenue cycle exposure in the way of denied claims, increased accounts receivable days, and time-consuming workflows associated with drafting appeals. Over the long term, revenue risk is associated with lower value-based payments.
Specificity is now the name of the game, and HIM departments must educate teams to code at the highest level under ICD-10. With thousands of new codes in play, it’s imperative that healthcare organizations address this issue through three critical steps: