Revenue Cycle Management
Review the scenarios 4.0, 4.20, and 4.36 (located in HIM Case Studies textbook). Use your textbooks and/or Internet research to help you thoroughly answer the following questions. Submit your answers to 4.0, 4.20, and 4.36 in a word document or pdf. References should be cited in APA format. Your answers will be graded in accordance with the attached rubric.
Case Study 4.0
1. Identify the issue with the codes/data.
2. What should the correct code(s) be? Why?
3. After changing the code(s), what impact might this have on the MS-DRG? Is reassignment of MS-DRH necessary or unnecessary to comply with coding standards? Why?
4. If reassignment is necessary, what is the correct MS-DRG? Why?
5. If reassignment is necessary, evaluate the impact this could have on billing.
6.. What training could you recommend to the coders to prevent this error from occurring in the future?
Case Study 4.20
1. Create a physician query to be used for the scenario.
Case Study 4.36
1. Determine any areas of inaccuracy in the CAC identification.
2. Recommend corrections to the code assignment.
3. Recommend strategies to be implemented to identify/correct coding errors in the event that CAC is adopted
Resources
ICD-10 CM Coding Guidelines FY21
ICD-10-CM/PCS MS-DRG v37.0 Definitions Manual
Guidelines for Achieving a Compliant Query Practice (2019 Update)
Physician Query Examples
APA format with any cited sources