RMC’s Blog

Post-COVID-19 Signs and Symptoms – Sequelae Continues

The daily news surrounding COVID-19 includes information and facts from those individuals who were diagnosed with COVID-19 but they now are in the recovery stage and have “Post-COVID-19” signs and symptoms.  A recent study in Nature Medicine (March 22, 2021),...

The OIG Workplan and Building Your Own Coding Compliance Program

Each year the Office of Inspector General (OIG) publishes their annual work plan for healthcare, which is a highly anticipated publication. The OIG Work Plan sets forth various projects including OIG audits and evaluations that are underway or planned to be addressed...

HCC Coding Audits . . . A Must!

The words “Hierarchical Condition Categories” or HCCs can conquer up some anxiety for HIM Coding, and Clinical Documentation Integrity (CDI) professionals, even for Revenue Cycle and Compliance leadership. Add to that, the word “audit” and we now have uneasiness and...

COVID Coding in 2021

We have all been keeping up with COVID-19 and the code and guideline changes that have evolved since original coding advice came out in February of 2020.  The advent of code U07.1 was a “game changer”. This code was created and made effective after April 1, 2020....

2021 Evaluation and Management Changes

Now that we have all been using the new 2021 evaluation and management guidelines for a couple months now, hopefully the new routine is getting more comfortable. Here are a few reminders of this years’ changes and documentation requirements that were effective as of...

Q1 AHA Coding Clinic for 2021 Released

The first quarter of the American Hospital Association (AHA) Coding Clinic for 2021 has been released and contains the updated AHIMA/AHA FAQ on COVID-19 coding, as well as the January 1, 2021 update to the Official Guidelines for Coding and Reporting.  In...

Get Your PEPPER . . . MS-DRG Data and More

The Program for Evaluating Payment Patterns Electronic Report (PEPPER) was developed in 2002 by TMF Health Quality Institute in support of CMS’ Hospital Payment Monitoring Program. State Quality Improvement Organizations (QIOs) began distributing PEPPER to the...

Compliance with Post-Acute Care Transfers (Discharge Status)

The Centers for Medicare and Medicaid (CMS) MLN Matters recently published (2/25/2021) a provider compliance reminder regarding “Post-Acute Care Transfers”, often referred to as the PACT rule, and the correct coding and billing for these inpatient hospital...