Ms. Moore started the presentation with an overview of compliance, which she said should be at the heart of any surgery center’s coding policies and procedures. Ms. Moore outlined seven fundamental elements to an effective compliance program, as outlined by the OIG. Those elements include implementing written policies, procedures and standard conduct.
Standardized procedures must be established for scheduling/patient registration, verification benefits, patient contact, coding and submission of insurance claims.
“The entire revenue cycle process begins at the beginning with scheduling and progresses through coding and claim submission,” Ms. Moore said. “Healthcare is ever-changing, and coding is on the brink of one of the most significant changes in 30 years. This coding, especially the documentation required to code accurately, will be a challenge.”
Ms. Richmond then switched gears to focus on the switch from ICD-9 to ICD-10, providing a review of differences in the two nomenclatures, ICD-10 documentation requirements and the challenges therein, pitfalls and implications of inadequate documentation and more.
“What I want to stress now is review your clinical documentation and how you can improve it as you head into ICD-10,” Ms. Richmond said. “The next phase will require much more clinical information for coding and reporting.”
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Surgical Care Affiliates CEO Andrew Hayek: 6 Observations on the State of the ASC Industry
5 Best Practices for Revenue Capture at Endoscopy ASCs
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