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Book Detail
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Risk Adjustment Documentation & Coding, 2nd Edition
Poe Bernard, Sheri
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Previous ISBN (13): 9781622027330 Category: Coding / Reimbursement Publisher: American Medical Association Imprint: American Medical Association Audience: College/higher education
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Synopsis:
Capturing risk in medical documentation and coding successfully gives a complete and accurate picture of your patients' health; but it is also critical for ensuring proper reimbursement, managing cost, projecting future resource requirements and delivering high- quality care. Chronic diseases are not outliers, especially in older patients. 80% percent of older adults have at least one chronic condition. If you have any Medicare patients with chronic conditions and if you are participating in Merit-based Incentive Payment Systems (MIPS), the AMA's Risk Adjustment, Documentation and Coding 2e (RA, 2e) will help you capture the care rendered so the severity of your patients' illnesses is adequately captured to reflect your utilization. If you omit risk-adjusting diagnoses because a specialist is managing the care of your patient's chronic condition, you are hurting your MIPS efficiency rating. Most chronic conditions will impact the overall health of the patient; therefore, they are appropriate to capture for your documentation. In a value and outcome-based health care environment, lack of specificity in ICD-10-CM coding and documentation has ripple effects for a practice and its patients, like - loss of important data and financial returns and increased patient risk. Continuity of care and a complete picture of a patient's overall health are key to quality care. Connecting diagnosis with comorbidities (causes) with ICD-10-CM codes (such as hypertension with heart disease or diabetes and hyperlipidemia with diabetes, etc.) for patients with chronic conditions helps improve care and documentation. RA, 2e, covers this in detail and can help you document your patient's health and wellbeing, and help you get the right reimbursement, especially for your high-risk patients.
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