Health Systems Management Network, Inc

HSMN Announces New Physician Clinical Documentation (PCD) and Hospital ICD-10, PCD/ICD-10 Billing & Coding Practices

 

Wellington, FL -- (ReleaseWire) -- 01/10/2013 -- For 27 years HSMN has worked with Medical staffs in Faculty Practice, Group Practice, and Individual medical practice in every possible setting and with every iteration of Coding. They have worked with Professional fee coding and hospital coding and found that there is a deficit of information by both Coders and Physicians in understanding each other’s work. To address this gap, HSMN has created their PCD/ICD-10 and hospital ICD-10 specialty practices.

Coders do not always understand the clinical context for the root basic procedure; Physicians, depending upon training, do not fully understand the level of specificity required in the ICD-9-CM (also procedures) and ICD-10-diagnostic and procedure coding.

While many of HSMN clients have focused on the training of Coders and choosing software to support the new coding scheme, the training of Physicians for medical coding and billing have not been as high a priority. When HSMN sorted coding errors and claims denial they found something very curious among many of their clients.

More than 50% of the errors were a result of poor or inadequate documentation and lack of understanding by the coders of the Clinical content. When this was presented to the clients, it was clear something had to be done. The result was the creation and implementation of HSMN’s program, PCD/ICD-10.

In this program they look at cases from the previous year based on targeted extrapolation of data. Cases are parsed using HSMN’s Case Deconstruction Methodology (CDM). They examine the claims to determine what was billed versus what was performed during the encounter/procedure.

After the analysis, a grand round is set up for each Clinical discipline to discuss the cases, each of which is presented by a Physician and a Coder. HSMN provides the analysis, the training of staff and role modeling for a more interactive relationship between Physician and Coder.

HSMN has developed a program that works and we invite you to call us 866-908-4226 for a consultation or email us at info@hsmn.com to determine how your Medical staff and your revenue can benefit.