Coding

tcrosslintcrosslin
edited May 2016 in Clinical & Coding
I have a question for the experts since I am not a coder. We have an account that is being audited by the RAC and our coder realized that the code for Pneumonia was missed by her and wants to send an appeal letter to RAC asking to add this code which will add an MCC. Our denial coordinator does not think she can do this. Does anyone know the answer or the coding guideline that I could present to the coder or denial coordinator?

Theresa Crosslin RN CM
Cookeville Regional Medical Center
931-783-2078
TCrosslin@crmchealth.org

Comments

  • kwilliams@halifaxrmc.orgkwilliams@halifaxrmc.org
    edited May 2016
    My knee-jerk answer would be that there would be an awful lot of correcting after the patient was dc home. What a chaotic mess. Whole idea is to try to get it correct prior to going out.




  • mdionperrymdionperry
    edited May 2016
    Our compliance department said that we cannot correct coding errors in conjunction with an audit.




  • gwojogwojo
    edited May 2016
    Per CMS the RAC is reponsible for over/underpayments. Go to CMS website for info.
    Sent from my BlackBerry 10 smartphone. From: CDI TalkSent: Tuesday, April 5, 2016 11:06 AMTo: gwojo@wowway.comReply To: cdi_talk@hcprotalk.comSubject: RE:[cdi_talk] Coding

    My knee-jerk answer would be that there would be an awful lot of correcting after the patient was dc home. What a chaotic mess. Whole idea is to try to get it correct prior to going out.

     

     

     



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