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New Focus on Process and Measure: Raising Data Quality with a Standard Coding Workflow and Benchmarks

Author: Wilson, Donna D; Hampton-Bagshaw, Kim; Jorwic, Therese M; Bishop, Jean; Giustina, Elizabeth

Source: Journal of AHIMA

Publication Date: March 2008




Establishing a standard coding workflow that incorporates continuous improvement and creating performance benchmarks is key to improving the quality of coded data.



HIM professionals who assign codes or manage coded data take responsibility for translating clinical....

Recovery Audit Program Changes

Author: Wilson, Donna D

Source: CodeWrite

Publication Date: February 2015



Editor's note: The Centers for Medicare and Medicaid Services (CMS) has delayed the commencement of work under the Recovery Audit contract for durable medical equipment (DME), home health (HH), and hospice reviews. For more information and further updates on this new development, please s....

Revisiting Unrelated Surgical Procedures (MS-DRGs 981-989)

Author: Wilson, Donna D

Source: CodeWrite

Publication Date: February 2016



Make a fresh start in the new year by revamping coding compliance plans to include a second level review of all claims that group into MS-DRGs 981-989 (Operating Room Procedure/Unrelated to Principal Diagnosis). Historically, MS-DRGs 981-989 have been "low hanging fruit" for outside audito....

New Changes De-Spookify Modifier -59

Author: Wilson, Donna D

Source: Journal of AHIMA - website

Publication Date: October 30, 2014



The proper application of modifier -59 (Distinct Procedural Service) has mystified many a coder. The Centers for Medicare and Medicaid Services (CMS) has recently indicated that modifier -59 is the most commonly used and abused of all the modifiers—mainly due to the fact that it is used to....

Can You Manage Managed Care?

Author: Willner, Sue

Source: Journal of AHIMA

Publication Date: July 2001


HIM professionals’ data management skills make them a hot property in many settings, but none more so than managed care. In this second installment of the Journal of AHIMA’s special series on managed care, the author describes the ways managed care organizations use data and how HIM....

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