Guide to Clinical Validation, Documentation and Coding 2021 - Softcover

Optum360

Softcover

ISBN 10: 1622546369 ISBN 13: 9781622546367

Publisher: Optuminsight Inc, 2020

Synopsis

This is a concise, re, and easy-to-follow tool for those problematic diagnoses and PCS inpatient procedures that are most often questioned by payers. This unique resource provides the extensive clinical criteria and ociated documentation necessary for code ignment. This tool also describes the clinical documentation needed for determining if the condition is a complication or when a medical condition qualifies as an additional diagnosis. Also included is an introduction to the query process and how DRGs, CCs, MCCs, POAs, and HACs affect reimbursement. CDI staff, coders, utilization review staff, and HIM managers can use this to systematically evaluate the clinical criteria that influence code ignments and patient care.
Key Features and Benefits: Covers many of the most challenging inpatient medical diagnoses and procedures, plus the clinical criteria that support code ignment. Provides detailed clinical criteria and physician documentation requirements needed to justify code ignments. Helps craft physician queries that address fine distinctions in a patient s medical condition and ensure appropriate reimbursement. Reimbursement impacts. Tutorials on additional factors that rely on concise, accurate documentation and impact reimbursement such as complications and comorbidities (CC and MCC), hospital acquired conditions (HAC), and present on admission (POA). Extensive clinical tools. Includes resources for how to interpret abnormal EKGs, lab values, and diagnostic test outcomes in addition to pharmacology and organism information. Identifies other terminology that would qualify as and translate into ICD-10-PCS specific root operations.

Edition details

• Publisher: Optuminsight Inc
• Publication date: 2020
• Language: English
• ISBN 10: 1622546369
• ISBN 13: 9781622546367
• Binding: Paperback
• Edition number: 1