August 3, 2023

4 Common Barriers to Achieving Quality Patient Outcomes

Quality assessment and process improvement (QAPI) activities are an important part of providing quality patient care. The Centers for Medicare and Medicaid (CMS), as part of their conditions of participation, requires QAPI programs for hospitals and hospices. CMS has also proposed making them required for home health providers and skilled nursing facilities. Strong QAPI programs that result in exemplary clinical outcomes are a key mechanism by which providers can position themselves to be a preferred partner in any…

Timely Documentation Failures Can Be Costly

Often, therapy documentation comes under an audit with focus on quality patient care, continuity of care, and supporting the medical necessity of the services provided for coding and billing. Although allegations of malpractice are raised less often, the importance of thorough documentation as a defense against allegations of malpractice cannot be overstated. Regardless of the reason for the documentation review, it is also important to remember appropriate documentation is necessary to prevent licensing board actions.…

Understanding ICD-10-CM Codes: The Important, Comprehensive, and Distinct Facts [Part 1 of 6]

The International Classification of Diseases, Tenth Revision, Clinical Modification, known as ICD-10-CM, is the required standard for reporting diagnoses or condition codes on all healthcare claims, including Medicare. When attending an ICD-10-CM course, one of the first instructions is to obtain and use the current ICD-10-CM Coding Manual, which is updated every October. It is emphasized NOT to search for code(s) from the internet, the phone, or a list of codes. Yes, use the actual…