ICD-10 Updates & review

Icd-10-cm/pcs changes ahead! Ensure you validate when updates will be available for your encoders/software systems. Be sure you have ordered 2017 Code Books Ensure all coders received ICD-10-CM/PCS update training Validate and monitor LCDs/NCDs

Tomorrow! Webinar discussing the 2017 Code Changes “Preparing for the End of the Code Freeze” Thursday, September 29th @ 11:00 a.m. Eastern

Grace period ends in 2 days Internal/external code audits Weekly denial trend report, by payer and denial reason Physician queries

ICD-10 Query Templates HCCS ICD-10 query templates Library of approximately 40 templates $500 Contact: jecronin@hccscoding.com While we are on the subject of queries, we want to be sure you are aware that HomeTown Health’s business partner, Healthcare Coding and Consulting Services or HCCS offers a library of 40 ICD-10 query templates that organizations can use indefinitely. Please use the contact information on this slide if you are interested in obtaining these ready-made queries for your organization.

Queries Develop a policy and procedure for your query process that determines: Will the query be a part of the permanent health record? Will the providers document on the query form, or will they be asked to document within the progress notes or as an addendum to the discharge summary? In deciding, determine if you would want to submit the query document to an auditor? Regardless of how the query is created (electronically or on paper), the organization must determine where to place the query within the chart and if the query will be a part of the legal health record. In addition, whether or not to provide copies of the queries in requests to auditors should also be determined. When fulfilling audit requests, organizations should submit all documents that support the claim, which may in fact be the entire legal health record. Many organizations choose to ask the provider to document answers to queries within the progress notes or as an addendum to the discharge summary. In order to address third-party audit concerns, it is best to have a CDI program that captures documentation concurrently rather than retrospectively.

Unspecified codes CMS Guidance regarding unspecified codes: “While you should report specific diagnosis codes when they are supported by the available medical record documentation and clinical knowledge of the patient’s health condition, in some instances signs/symptoms or unspecified codes are the best choice to accurately reflect the health care encounter. You should code each health care encounter to the level of certainty known for that encounter. If a definitive diagnosis has not been established by the end of the encounter, it is appropriate to report codes for sign(s) and/or symptom(s) in lieu of a definitive diagnosis.”