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8 Sure-Fire Ways To Maximize Your Coding ROI

After the advent of ICD-10, many home health and hospice organizations discovered outsourcing as the most efficient and economical coding option. To ensure your coding ROI (return on investment) is fully maximized, there are certain practices and precautions you need to implement NOW!

Sure-Fire Ways To Maximize Your Coding ROI

The following 8 tips are from the front lines, as observed by certified coders. Straight from the “horse’s mouth” these professional coders are responsible to code for numerous organizations. Sure-fire ways to maximize your coding ROI include:

  1. Complete and consistent physician’s notes. With ICD-10, notes can’t just include the generalities of the past. For home health, they must back up skilled care need and homebound status. For hospice, physician records must include reasons death will occur in 6 months or less if disease follows its normal course. Physician notes must be consistent with other care providers in regards to both diagnosis and condition severity.
  2. Keep physicians informed and “on the same page.” Home health clinicians must work within the five-day evaluation window to prevent coding inconsistencies. If current diagnoses are not included in physician-sourced documentation, communicate quickly to get physician’s agreement to the plan of care. Coders also suggest faxing the initial OASIS so the physician is fully informed from the get-go.
  3. Clinicians required to document aide supervision at least every 14 days. With ICD-10, supervision documentation requirements are broader, and have greater consequences. It is especially important to document dates of missed aide visits, what was done or not done when aide did not follow the care plan, what clinician did to correct situation and that the physician was notified.
  4. Fully document even routine visits. Catheter changes and refilling medication boxes may seem too routine to require full documentation each visit—but that is not how CMS views it! For example, to prevent denials, record why patient is unable to visit the doctor’s office for catheter changes and why pharmacy prefilled or bubble pack medications can’t be used.
  5. Use measurable goals when applying for recertification. Effective January 1, 2016, additional information is required to recertify continued care. Measurable goals must be established, progress towards these goals documented and why continued skilled homecare is needed, must be detailed. “Paint the picture” of patient’s condition and necessity for continued homecare visits and prevent recertification denials!
  6. Keep up a high OASIS submission rate. Currently, the OASIS required submission rate is 70%, but in July 2016, submission rates will increase to 80%. By 2018, the standard will be 90%. Access your accepted OASIS submission rates via CASPAR. Prevent lost revenues due to uneducated clinicians leading to OASIS errors and unaccepted submissions. Be careful to fully document on SOC, EOC and ROC where applicable, to ensure OASIS acceptance and high OASIS quality scores.
  7. Invest in additional coding and documentation education. Expecting your clinicians to be adept at completing all the tasks listed here to maximize your coding ROI, will require continued education. Are you able to produce ongoing reports showing which clinicians make OASIS and documentation errors? Do your managers have time to provide ongoing training for the clinicians making errors leading to decreased coding ROI? Kenyon HomeCare Consulting experienced QI staff can provide training on site or via webinar.
  8. Maximize coding ROI by engaging an experienced outsourcing company. Consider Kenyon HomeCare’s Coding Plus program, Our certified professional coders have a minimum of three years’ of experience doing nothing but coding. We will work with your organization to ensure OASIS integrity, avoidance/elimination of documentation inconsistencies, and maximum reimbursements.

Outsource To Maximize Your Coding ROI

Contact us today to schedule an appointment to learn more or call 206-721-5091 to get started! Let us show you why outsourcing is the most efficient and economical coding option for your organization!

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