ICD-10 Coding Audits

Screen Shot 2015-11-05 at 2.13.06 PM

Raise Your Coding IQ! Introducing ICD-10 Coding Audits

Pathway Health is now performing ICD-10 Coding Audits for post-acute care organizations! These audits help organizations determine opportunities for improvement, while also reviewing the proper ICD-10 codes to use for billing.

Both remote and onsite ICD-10 Coding Audits are affordable, efficient ways to be better informed about education needs, billing practices, and optimization of payments for chronic disease management and short-term rehabilitation. Audits can be completed by remote access to software or by encrypted delivery of coding/diagnosis listings.

Your Pathway Health ICD-10 Coding Audit will be coordinated by an RHIA (registered health information administrator), who has experience in coding ICD-10, to give feedback on your ICD-10 coding process and provide billing guidance.

Why choose Pathway Health’s ICD-10 audit solution?

  • Clinical documentation improvement is key for proper reimbursement in ICD-10.
  • Clients honing their ICD-10 skills are able to correct miscoding now, so future ICD-10 coding is accurate.
  • Most clients admit they are not skilled in ICD-10 coding, so it is difficult for them to find their own areas of concern. Pathway Health provides you with tips and recommendations for success.
  • This process will kick start your efforts to clean up your diagnosis lists, as you bill in ICD-10.
  • This audit is affordable, and can be completed remotely.
  • Process improvement can only begin if you know where your needs are. A Pathway Health ICD-10 Coding Audit provides information on the exact training and education needs for your leaders and line staff.
  • Pathway Health’s tools and resources help you adhere to official ICD-10 coding guidelines.

Keep on the Right Path with ICD-10 Coding Audits

A Pathway Health ICD-10 Coding Audit is a comprehensive analysis of your coding process, which includes the claim check review process and coding techniques for ICD-10. Executive summaries and action plans are provided as part of our comprehensive assessments.

Components reviewed include:

  • Primary diagnosis
  • Admitting diagnosis
  • Reason for continued stay
  • Medical diagnosis (reason for Medicare)
  • Rehab diagnoses
  • Psychiatric diagnoses
  • Status of tubes (e.g., catheters, colostomies, etc.)
  • Encounters vs. status of…
  • Z codes
  • Late effects
  • Therapy treatment codes
  • Dementia coding
  • Sepsis coding
  • External cause codes
  • Diabetes codes
  • End stage renal disease
  • Acute exacerbation of diseases vs. chronic diseases
  • Coding for Section I of the MDS

Choose from Three Coding Audits Solutions

1. Remote Coding Audit – Basic

  • 12 Diagnosis List Audit, including both short-term and long-term records
  • Snapshot analysis of resident health status
  • Accuracy in selecting primary, secondary and reason for continued stay diagnoses
  • Executive summary, with tips for coding instruction

2. Remote Coding Audit – Advanced

  • 18 Diagnosis List Audit, including both short-term and long-term records
  • Snapshot analysis of resident health status
  • Accuracy in selecting primary, secondary and reason for continued stay diagnoses
  • Executive summary, with tips for coding instruction

3. Onsite Coding Audit – Comprehensive

  • 12 comprehensive chart reviews, including:
    • History and physical
    • Discharge summary
    • Physician orders
    • Progress notes
    • Consultation reports
    • Diagnosis listings
  • Short-term rehabilitation and long-term resident reviews
  • Snapshot analysis of resident health status
  • Accuracy in selecting primary, secondary and reason for continued stay diagnoses
  • Late effects
  • Z codes
  • Capturing codes for Section I of the MDS
  • Action plan tips for coding instruction

Contact Pathway Health to ensure your organization remains ICD-10 strong!