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A formula for improved financial outcomes? Or a recipe for fines and penalties? In fact, the use of certain ICD-10-CM diagnosis codes mapping to hierarchical condition categories (HCCs) can be both. On one hand, these diagnosis HCC codes provide revenue enhancement by risk-adjusting payments to account for sicker Medicare and Medicare Advantage beneficiaries. But using the wrong ICD-10-CM codes and/or relying on weak clinical documentation can increase your compliance risks and may result in adverse auditor determinations. In recent months, the Office of the Inspector General (OIG) has published several reports detailing noncompliant HCC coding and documentation leading to overpayments.
As Gloryanne Bryant explains in this ICD10monitor webcast, reducing your compliance risks starts with an effective HCC auditing program, performed by an internal team and/or by an outside consulting firm. Through ongoing audits, you can uncover coding risks, gaps and vulnerabilities in your current documentation and coding practices and then take prompt corrective action — before you come under external auditor or regulatory scrutiny.
Why This is Relevant:
Much is riding on the accuracy of your HCC diagnosis coding and the strength of the supporting documentation, both in terms of bottom line impact for your organization and the capture of data that enables CMS to estimate future spending. Consequently, the OIG and other auditors are shining an increasingly bright light on payments involving HCC risk-adjusted patients. Noncompliance can prove to be very costly, not just financially, but also operationally and in the damage to your organization's reputation.
Learning Objectives:
- Understand your compliance risks and how HCC auditing can lead to improvements
- Reinforce your knowledge of Medicare Advantage risk-adjustment HCC requirements and many high-risk ICD-10-CM diagnosis codes
- Comprehend OIG reports and the recommendations for Medicare Advantage risk-adjustment HCCs
- Identify risks, gaps and vulnerabilities in your clinical documentation and ICD-10-CM coding
- Learn how to improve coding accuracy, data integrity and compliance with HCC auditing practices
Who Should Attend:
This webcast will be most relevant to HIM coding directors/managers, hospital inpatient and outpatient coders, revenue cycle directors/managers, compliance directors/managers, HCC coding consultants and auditors, and educators.
Webcast Access Privileges: Only one login is allowed per webcast purchased. Discounted pricing for additional registrants is available. For more information about webcast pricing and requirements, click here.
About the Presenter
Gloryanne Bryant, RHIA, CDIP, CCS, CCDS
Gloryanne is an HIM Coding professional and Leader for over 40 years. She has an RHIA (Registered Health Information Administrator), a Clinical Documentation Improvement Practitioner (CDIP), a Certified Coding Specialist (CCS), and a Certified Clinical Documentation Specialist (CCDS). Gloryanne is also an AAPC (American Academy of Professional Coders) member.
In her past, she was the National Director of Coding Quality, Education, Systems and Support for a national healthcare system. Gloryanne managed and was responsible for the coding quality, accuracy, and integrity, monitoring programs, education, coding related systems and served as an advisor for Clinical Documentation Improvement (CDI). She was also the key national leader for ICD-10 Coding Education and Training from 2010 to mid-2016. Prior to May 2009, she was the Corporate Senior Director of Coding HIM Compliance for Catholic Healthcare West (CHW), Dignity Healthcare for more than eight years. Currently she is an independent coding compliance consultant where she advises, guides, and educates healthcare organizations, practices and professionals on clinical documentation improvement and compliant clinical coded data.
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Continuing Education
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This program has the prior approval of AAPC for 1.0 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.
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This program has been approved for 1.0 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
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Please Note: All webcasts will offer a Certificate of Attendance (COA). If we do not offer the CEUs the attendee is looking for, attendees can take the COA and try to apply to the agency of their choice.
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