Wound care coding is fraught with serious documentation and compliance issues which is why this topic continues pose problems for coders and engage auditors. And yet, there are clinical documentation integrity (CDI) and quality opportunities which tend to have a favorable impact on facility reimbursement as you will discover during this webcast on a topic that is always seems to be in demand.
Accurate documentation of wound care is essential in order to reflect what has been done as often times physicians will forget to document the size of the wound. And this lack of specificity impacts the code selection such as depth, location, the instrument used, and whether the wound was present on admission. And since the physician documentation does not always match the nursing documentation, it is important to establish a "source of truth" regarding the wound stage.
And yet, there are CDI and quality opportunities which impact the reimbursement for the facility. For example, you will want to determine if the debridement is excisional versus non-excisional for CPT® and ICD-10-PCS assignment. The type of debridement impacts the CPT and ICD-10-PCS code selection. Excisional debridements impact the MS-DRG assignment since an excisional debridement will ultimately be paid at a higher rate than non-excision on the inpatient side. You will also need to ensure that any skin replacements are accurately captured. When the procedures are coded, but the "skin" supply is not charged, reimbursement is negatively impacted. You will also need to know if a separate visit code can be charged on the outpatient visit in addition to the debridement code. This can be a compliance issue if the visits are coded when only a scheduled debridement is performed.
Wound care coding also impacts the inpatient quality score as it is included as a Hospital Acquired Condition (HAC). Pressure injuries at stage III and IV can impact a facility's quality results if they are not present on admission.
Finally, if you are looking for answers to specific wound care cases, please send those cases to firstname.lastname@example.org and every effort will be made to include them in this webcast.
Why This is Relevant:
This topic is relevant because it is frequently reviewed by government and third-party auditors.
From this exclusive ICD10monitor webcast by Laurie Johnson you will…
- Learn about the basics of wound coding basics, while gaining an intermediate to advanced understanding of potential issues;
- Understand the 2019 updates that impact wound code assignment;
- Learn about associated charges and costs that impact the outpatient codes;
- Understand the MS-DRG and APC impacts; and
- Benefit from practicing with real cases.