THE PHYSICIAN QUERY PROCESS
In order to assign the most appropriate ICD-10-CM diagnostic code, clear, precise diagnostic information must be provided by the practitioner. Lack of such information leads to the assignment of an unspecified ICD-10-CM code. Unfortunately many unspecified codes are mapped to "Return to Provider" under the Patient Driven Payment Model (PDPM). Throughout the ICD-10-CM Coding Guidelines as well as in the AHA Coding Clinic, those assigning the diagnostic code are directed to 'query the provider' to obtain clarity and subsequently be able to assign the most appropriate code. However, the querying process is not without risks of accusations of fraud. There are specific criteria which must be incorporated in the querying process. These criteria will be addressed during this webinar, including the provision of sample querying tools.
There are no continuing education hours provided for this session.
Mary Ann P. Leonard, RHIA, RAC-CT
Mary Ann P. Leonard, RHIA, RAC-CT owner and operator of Health Information Professionals, a health information management consulting company. Health Information Professionals holds contracts for HIM consulting services with over 100 facilities in Pennsylvania, Delaware and Maryland. A graduate of Temple University’s Health Information Management program, Mary Ann has worked as a Medical Records Consultant in long term care for over 3 decades. She has conducted educational programs on various medical records related topics and conducts the medical record portion of the Nursing Home Administration program for several NHA programs in Pennsylvania. She has presented on a number of HIM related topics for the Pennsylvania Health Information Management Association, the New Jersey Health Information Management Association, the Long Term Care Spring Conference sponsored by the American Health Information Management Association and various other professional associations. Mary Ann is also active in the Pennsylvania Health Information Management Association and the American Health Information Management Association by holding various positions and membership in the Long Term Care Practice/Continuity of Care Council. She is an AHIMA Approved ICD-10-CM trainer. She is a founding and charter member of the Pennsylvania Association of Nurse Assessment Coordinators.
The Physician Query Process
Fri, Nov 22, 2019 12:00 PM - 1:30 PM EST
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