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This week's post comes from National Compliance and Quality Audit Manager, Sharon Nichols, BSBEB, RHIT, CCS, CHTS-TR.

The landscape of physician coding changed dramatically in 2015 with the implementation of ICD-10 and MACRA. This coupled with the continued trend of health systems acquiring physican practices has put a greater emphasis on coding of professional services. These factors have contributed to many organizations choosing to integrate phyisican coding into their HIM department.  

This week's post comes from National Compliance and Quality Audit Manager, Sharon Nichols, BSBEB, RHIT, CCS, CHTS-TR.

by Julia Hammerman, Director of Education and Compliance, and Sam Champagnie, Senior Director, HIM Operations

The newness and specificity of ICD-10 ushered in a stronger focus on clinical coding audits. From internal reviews to external coding audits, healthcare organiza­tions nationwide are revisiting tried-and-true audit practices with ICD-10 coding quality in mind. Diagno­sis-related group (DRG) validation audits under ICD-10 have also become more strategic to realize revenue cycle success.

In 2015, himagine conducted its inaugural HIM Benchmark Survey in the midst of the preparation for ICD-10. At the time, approximately 56% of respondents reported that they planned to outsource at least a portion of their coding. In our 2016 survey, 63% of respondents indicated that they outsource, making it clear that most healthcare providers currently rely on some coding vendor resources and will likely continue to work with outsourced coders going forward.

In our soon to be released second annual HIM Benchmark Report, 70% of HIM leaders indicated they increased auditing efforts in 2016 and a whopping 96% projected to maintain or increase this level of auditing in 2017.

This week's post comes from National Compliance and Quality Audit Manager, Sharon Nichols, BSBEB, RHIT, CCS, CHTS-TR.

This week's post comes from National Compliance and Quality Audit Manager, Sharon Nichols, BSBEB, RHIT, CCS, CHTS-TR.

The next wave of the ICD-10 transition may help Organizations increase revenue through higher level of specificity in claim submission.  The key to this success is driven by continuous monitoring of coding accuracy.

In today’s shifting healthcare landscape, the evolving disciplines of HIM, clinical documentation improvement and healthcare informatics are merging.  The recent implementation of ICD-10 offers additional opportunities to further specify the patient’s condition that enhances provider communication as well as accurate reimbursement.  As risk base insurance models increase, many organizations are in the process of expanding their clinical documentation improvement efforts in order to drive optimized revenue and compliance.