AHIMA2018 術後合併症コーディングを多用していませんか?

米国でも問題となっている術後合併症コーディング。
世界各国どこでも包括制度を導入しているとこはUPコーディング問題(医師やコーダー)が課題。
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Surgical Complication, or Not, That Is the Question
https://ahima.confex.com/ahima/90am/meetingapp.cgi/Session/12362
Identifying whether a condition, which occurred in the operative suite or in the post-operative period, is a surgical or post-operative complication can be challenging, even for the most seasoned professionals. Dr. Adriane Martin, a board-certified general surgeon, will cover common intra-operative complications and post-operative conditions. This presentation will provide the participant with a clear understanding of these events/conditions, as well as advanced case studies for discussion.

Handout
https://ahima.confex.com/ahima/90am/recordingredirect.cgi/oid/Recording1942/session12362_1.pdf

Summary
・ A cause and effect relationship must exist
- The term “post-operative” does not always define a cause and effect relationship
・ The physician must state that a complication has occurred
・ Inherent/Expected conditions do not constitute a complication
- Unless, they require unexpected resource use or prolong hospitalization
・ Some conditions may be the result of the disease process rather than a complication
- When in doubt, query

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Compliance Risks Associated with DRG Mismatches
Saturday, September 22, 2018  3:00 PM – 4:00 PM
Miami Beach Convention Center (MBCC) – Ocean Drive Ballroom A-H
https://ahima.confex.com/ahima/90am/meetingapp.cgi/Session/12404
This engaging session will provide an analysis of DRG mismatches and strategies for monitoring and management surrounding this process. Accompanying the ICD-10 transition is an increase in DRG mismatches due to circumstances that include documentation issues, grouper logic issues, and use of both ICD-10-CM and ICD-10-PCS. This presentation discusses each of these issues and how collaboration between CDI and coding can positively impact overall DRG mismatches. Each of the factors in the accuracy of DRG assignment is a crucial piece of a compliant revenue cycle process.

Handout
https://ahima.confex.com/ahima/90am/recordingredirect.cgi/oid/Recording1948/session12404_1.pdf

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Coding Edits: Are You Bypassing the Road to Compliance?
https://ahima.confex.com/ahima/90am/meetingapp.cgi/Session/12421
This presentation will benefit outpatient and professional fee coders and billers as well as compliance auditors, physicians, and non-physician practitioners. It will help the audience understand the use of the NCCI policy manual, coding edits, and compliance risks associated when bypassing coding edits.

Handout
https://ahima.confex.com/ahima/90am/recordingredirect.cgi/oid/Recording2037/session12421_1.pdf

 

 

追伸)久々にAHIMAエンゲージを訪れてみると、ご覧のとおりアクティブな質問の殆どがコーディング。
簡単なものから複雑なものまで多岐。現場でも困っている状況が窺えます。

AHIMA-ENGAGE-icd-coding.png

 

 

It’s Complicated: Post-Operative Complications
Posted By AHIMA Staff on Oct 25, 2018
By Lou Ann Wiedemann, MS, RHIA, CDIP, CHDA, FAHIMA
This monthly blog will discuss all the components of quality clinical documentation with a comprehensive approach to cover all areas of the healthcare industry.
http://journal.ahima.org/2018/10/25/its-complicated-post-operative-complications/

A post-operative condition must include all the following:
・It must be more than a normal expected outcome of the procedure.
・It must be evaluated, monitored, and treated by the provider.
・A cause-and-effect relationship between the care provided and condition must exist.
・The provider must clearly document that it is a complication.

 

AHIMA2018 術後合併症コーディングを多用していませんか?

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