For an agency in order to remain
compliant and maintain the revenues, it is essential to have accurate coding
with the highest level of specificity. Creating and maintaining a strong code
of conduct sends a potent statement to employees, customers, as well as business
associates.
A strong code that is aligned to
corporate values and ethics sends a message of comfort to those committed to
those principles. Fraud in healthcare is being exposed at an increasing rate.
RAC, MAC, and Z-PIC audits as well as HEAT raids have uncovered hundreds of
millions of dollars of false claims filed. Due to a growing mistrust of
provider ethics, it becomes essential to take a strong stand. You can get a lot
of home health ICD-9 medical coding training online with various home health conferences.
Various diagnoses could be slapped with
denial due to probe edits and recertification. In case the file is pulled
and it lacks clear documentation that it is with substantial and challenging
effort for the beneficiary for leaving home, the episode or specific visits might
be then denied for lack of homebound status.
Claims can also be denied in case skilled nursing care is not intermittent. In order to meet the requirement for “intermittent” skilled nursing care, a beneficiary is ought to have a medically predictable returning need for skilled nursing services.
Your agency corporate compliance audits
must monitor clinical documentation on a frequent basis. Furthermore, having a
sturdy Corporate Compliance Program with a strong Code of Conduct can go far to
lessen risk. Audits of work products and processes can alert leaders to the
plan’s efficiency. You must ensure that the documentation must be reviewed
regularly.
Adequate documentation begins with the
accurate diagnosis and being alert for edits. In addition to agency PI
projects, you must consider professional coding teams to reduce risk. Third
party coding and auditing can provide the buffer required to reduce risk and
increase compliance
Get more medical coding training online through a wide range of home health conferences at AudioEducator
