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How to Eliminate Pesky Coding And Documentation Issues

ICD coding and clinical documentation issues are often persistently recurrent, increasing the stress levels of coders, clinicians, and managers. And chronically suppressing your homecare organization’s bottom line. Prevent coding and documentation problems from becoming pesky houseflies buzzing about and always coming back no matter much you ‘swat’ at them.

Pesky Coding and Documentation Issuesdocumentation issues

In reality, your coding and documentation situations aren’t nearly as hopeless as summer flies! There are real solutions to the very real coding and documentation issues you are facing. But before learning how to skillfully ‘swat’ those pesky problems away, first assess their position and take careful aim!

  • Difficulty in matching diagnoses to correct codes. ICD-10’s tens of thousands of individual codes and seven alpha-numeric characters are directly reflective of its great complexity and specificity. Both primary diagnoses and comorbidities must be indicated. For maximum reimbursement, it’s essential coders not lump together similar conditions. Each diagnosis needs a distinct code.
  • Constant claim delays and denials. Certified home health & hospice coders receive training needed to understand the nuisances unique to homecare coding. Specific homecare knowledge includes required minimum OASIS integrity scores and increased recertification requirements, as of January 2016. Furthermore, inaccurate, incomplete coding education leads to claim delays and denials.
  • Outdated coding resources. Not only major, industry-altering shifts like the ICD-9 to ICD-10 transition, but less noticeable and yearly updates also occur. Coders must constantly keep their abilities up to date. Be aware of CMS tools and updates to prevent falling behind and suffering the consequences.

And More Documentation Problems…..

  • Documentation is incomplete or inadequate. Coders must have complete clinical documentation to support diagnosis codes. When essential information is omitted from the OASIS, or client goals/outcomes aren’t sufficiently detailed, your bottom line is affected. In addition, tracking down clinicians for missing data slows your claim submissions and causes rework.
  • Clinical documentation is always late. Some agencies struggle so much with tardy documentation that they introduce enforcement policies. These strategies result in suspensions or even terminations for consistently late documentation. However before imposing these policies, gather data to identify specific clinicians needing additional education. Pressuring clinicians to hurry without building up their skill level leads to incomplete or inadequate documentation.
  • Documentation is not consistent and/or ‘on the same page.’ Your agency must be in sync with other providers under ICD-10. Documentation must consistently show that clients need to be cared for at home by skilled clinicians. As a result, all visit notes, plan of care, OASIS, and physician documentation must match to receive the optimal reimbursement for the services rendered.

Solutions for Pesky Coding and Documentation Issues

Coding and documentation problems, along with the failure of coders and clinicians to properly communicate, leads to poor claim submissions. This, in turn, leads to re-submissions, reduced reimbursements, and even rejected claims. Additionally, when your coders keep having bad days, they suffer undue stress, which reduces their quality and speed of work further.

So what is the answer? Depending on your specific situation, the four main ‘swatters’ to use on those coding and documentation issues that just won’t go away are:

  1. Hire experienced certified home health and hospice coders
  2. Invest in re-training current coders and clinicians
  3. Outsource your coding temporarily basis while ‘getting your house in order’
  4. Outsource permanently and put your coding into the hands of dedicated, highly skilled professionals

Kenyon HomeCare Consultants can help quash your pesky coding and documentation issues with permanent or temporary outsourcing using the Coding Plus program. Kenyon uses only certified home health and hospice coders with years of coding experience. We offer comprehensive help with improving your clinical documentation and can provide on-site or webinar coding and documentation education.

Contact us to schedule an appointment or call 206-721-5091 today!

Category: ICD Coding

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