Avoiding denials due to ICD-9-CM coding.
Regional Home Health Intermediaries (RHHIs) continually report a high incidence of PPS denials due to incorrect diagnosis. These down-coded claims result in a lower payment to agencies for services already provided. This article helps clinicians and clinical managers address processes in their agency to assure denials are diminished and, hopefully, eliminated.
Abraham
Prinny Rose
PR
prinny@hiqm.com
D014487:Centers for Medicare and Medicaid Services, U.S.; D003951:Diagnostic Errors; D004194:Disease / Q000145:classification*; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D007345:Insurance Claim Review; D038801:International Classification of Diseases; D011445:Prospective Payment System; D014481:United States