Kenyon HomeCare ConsultingICD-10 Coding Moving Forward Into PDGM: Does Your Program Have What It Takes To Thrive Or Are You Setting Yourself Up For A Big Fall? You Can't Build Your House On A Weak Foundation. - Kenyon HomeCare Consulting (206) 721-5091

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ICD-10 Coding Moving Forward Into PDGM: Does Your Program Have What It Takes To Thrive Or Are You Setting Yourself Up For A Big Fall? You Can’t Build Your House On A Weak Foundation.

OutsourcingICD-10 coding is crucial for today’s home health world. However, agencies still do not accurately reflect patient care with the specificity of codes. This leaves money on the table and leaves CMS to wonder about things like case mix creep. In the world of PDGM, you cannot afford to miss out on proper coding and development of visit protocols to go with it.  

Common ICD-10 Coding Mistakes: 

Many agencies do code on-site. If you are one of those agencies, then make sure your coders have the skill to do justice to your coding. Here are common errors with ICD-10 coding: 

Knowledge: So many smaller agencies have someone code that is self-taught. You cannot afford this regardless of the number of Medicare admissions you do.  

Fear: Yes, that is exactly right. Sometimes, coders will stay away from higher specificity coding due to lack of the knowledge. This leaves money on the table. Ultimately, you do not need to fear repercussions from audits if things are properly completed. Upcoding is not ok but making sure you receive proper reimbursement is.  

Time: Many agencies have coders that fill multiple roles within the agency. Coding properly is a significant job. Often, coding properly can become secondary to other work functions at your office. If your coder is also an admin assistant, then does he or she really have the time to give coding its due? Or, will you see common non-specific codes because it is quicker and easier.  

Operations Based On Medicare Census: Your coding needs to be correct regardless of how much Medicare business you do. Many agencies that focus mainly on Medicaid do not worry as much about coding since it is not tied to reimbursement the say way. This is not the way to do things. CMS compiles this data and then “sees” a picture with less acute patients. So, filling out the Oasis and codes properly is more important than ever rolling into a PDGM world.  

PDGM and Beyond:

Along with correct Oasis, ICD-10 coding with be crucial in development of visit protocols to sustain you in a PDGM world. Business as usual will not work. You have probably heard that many times this year. But, if you are struggling with how to change things, then the time is now. Consider outsourcing your coding in small agencies. It is not fiscally sound to have someone trained and to maintain competency of coding skills in a small agency. Moving into PDGM is a great time to transition the coding outside. Choose coding only from certified coders that make sure you have the data needed in your chart to justify your codes. If you have proper documentation to justify your codes, then auditing may be cumbersome, but ut usn’t scary. 

Kenyon Homecare Consulting ICD-10 Coding Program:

At Kenyon Homecare Consulting, we can help with all your coding needs. Whether you just need the coding done or need assistance with billing, the services are here. We have certified coders who can help make sure you get the dollars you deserve for care of the patients you see.  Call us today at 206-721-5091 or contact us online to see how we can help you!  

Category: ICD Coding

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