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Risk Adjustment Documentation & Coding (Paperback, 2nd Revised edition)
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Risk Adjustment Documentation & Coding (Paperback, 2nd Revised edition)
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Risk-adjustment practices consider chronic diseases as predictors
of future health care needs and expenses. Correct and detailed
documentation and compliant diagnosis coding are critical for
proper risk adjustment.Risk Adjustment Documentation & Coding,
2nd Edition provides: Risk-adjustment parameters to improve
documentation related to severity of illness and chronic diseases.
Code abstraction guidelines and recommendations to improve
diagnostic coding accuracy without causing financial harm to the
practice or health facility. Chronic disease ICD-10-CM coding
summaries for quick reference and study. The impact of
risk-adjustment coding (hierarchical condition category (HCC)
coding) on a practice should not be underestimated: More than 75
million Americans are enrolled in risk-adjusted insurance plans.
This population represents more than 20% of those insured in the
United States. Insurance risk pools under the Affordable Care Act
include risk adjustment. CMS has proposed expanding audits on
risk-adjustment coding. FEATURES AND BENEFITS Five chapters
delivering an overview of risk adjustment, common administrative
errors, best practices, and guidance for development of internal
risk-adjustment coding policies. Ten chronic disease ICD-10-CM
coding summaries for quick reference and study. Two appendices
offering mappings and tabular information of ICD-10-CM codes that
risk-adjust to HCCs and RxHCCs. Learning and design features:
Vocabulary terms highlighted within the text and defined at the
bottom of the page. Advice/Alert Notes that highlight important
coding and documentation advice from federal regulatory sources.
Sidebars that provide derivative story and additional information,
such as Coding Tips that guide coders with practical advice from
sources like AHA's Coding Clinic and cautionary notes about
conflicts and exceptions Clinical Examples that underscore key
documentation issues for risk adjustment Clinical Coding Examples
that provide snippets or full encounter notes and codes to
illustrate risk-adjustment coding and documentation concepts
Documentation tips that highlight recommendations to physicians
regarding what should be included in the medical record or how
ICD-10-CM may classify specific terms Examples that explain
difficult concepts and promote understanding of those concepts as
they relate to a section FYI call outs that provide quick facts
Abstract & Code It! exercises that test diagnosis abstraction
and coding skills (exclusive to Chapter 4) Extensive end-of-chapter
Evaluate Your Understanding sections that include multiple-choice
questions, true-or false questions, audit and Internet-based
exercises. Two downloadable course tests and slide presentations
for each chapter. Exclusive content for academic educators: A test
bank containing 100 questions and a mock risk-adjustment
certification exam with 150 questions.
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