Heart Failure under MS-DRGs (Audio Conference)

AUDIOCONFERENCE ON CD OR AUDIO ARCHIVE

Sponsored by Briefings on Coding Compliance Strategies

presented on March 14, 2008

Turn heart failure under MS-DRGs into a profile and coding success!

Heart failure is the primary reason for many hospital admissions— but despite the volume of occurrences, it is often under-documented by physicians. Under the new MS-DRG system, coders are burdened with added pressure to come up with appropriate CCs and MCCs without the appropriate documentation. And coding staff don’t always have the clinical know-how to find opportunities for physician queries.

As a result, your facility’s MS-DRG reimbursement—and your physician profiles—can flat line.

During HCPro’s audioconference, Heart Failure under MS-DRGs: Get complete documentation to ensure appropriate reimbursement and optimal profiles, our two physician speakers, Robert S. Gold, MD, from the coding perspective, and James S. Dunnick, MD, F.A.C.C., a heart specialist, help you show your physicians “what’s in it for them.” This 90-minute program also educates coders on complex cardiology terms, conditions, and treatments, and explain when and how it is appropriate to ask physicians for clarification. You’ll gain insight on how heart failure impacts MS-DRGs and the 2008 inpatient prospective payment system. And you and your staff will be able to accurately report ICD-9-CM codes for heart failure cases.

TAKE A LOOK AT THE AGENDA

1. How heart failure coding affects hospital reimbursement and physician profiles
1. Hospital reimbursement, including CCs, MCCs, MS-DRGs
2. Physician profiles and publicly available data
3. The importance of documentation for accurate code assignment
2. Clinical indications/terminology of heart failure
1. Differences between:
   1. Heart failure
   2. Ventricular dysfunction
   3. Cardiomyopathy
2. Diseases that cause heart failure
3. Treatments: 
   1. Medications
   2. Surgical options
   3. Electrophysiology treatments
3. Clinical indications and correctly coding heart conditions
1. Review of appropriate ICD-9-CM codes
2. Clarifying clinical indications with physicians
3. Educating physicians on documentation requirements
4. Case examples

A question and answer session follows the presentation.

LEARNING OBJECTIVES

By the end of the program you’ll be able to:

1. Identify how heart failure  impacts MS-DRGs and the 2008 inpatient prospective payment system
2. Classify the clinical indicators and common treatments of heart failure cases
3. Accurately report ICD-9-CM codes for heart failure cases
4. Explain the impact of insufficient physician documentation on both facility reimbursement and physician profiles
5. Determine when and how it is appropriate to ask a physician for clarification, including how to formulate questions (queries)

BONUS TOOLS

In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials and

• Sample physician query (clarification) form
• Codable form for use with core measures for heart failure
• Related CDI Journal article from HCPro

These materials are provided with PDF links.

MEET THE SPEAKERS

Robert S. Gold, MD, is founder and CEO of DCBA, Inc., in Atlanta, GA, a consulting firm that provides physician-to-physician educational programs in clinical documentation improvement, including the training of liaisons to perform concurrent review and of HIM professionals to understand the clinical aspects of diseases and procedures to which they assign codes. He has more than 41 years of experience as a physician, medical director, and consultant. Dr. Gold writes Clinically Speaking for Briefings on Coding Compliance Strategies and Minute for the Medical Staff for Medical Records Briefing, and is the author of the training handbook, Documentation Strategies to Support Severity of Illness: Ensure an accurate professional profile, all from HCPro.

James S. Dunnick, MD, F.A.C.C., is a member of the Cardiovascular Specialists of Southwest Louisiana in Lakes Charles, LA, a group of board-certified cardiologists who offer patients in Southwest Louisiana experienced, comprehensive cardiac care with a focus on prevention and early intervention. Dr. Dunnick’s special interests include heart disease in women, preventive cardiology, congestive heart failure, hypertension, and cholesterol problems, and he has been doing lectures and presentations on many of these topics for over 20 years. He is board certified in internal medicine and cardiovascular diseases and is a fellow of the American College of Cardiology and the American College of Physicians. Dr. Dunnick attended the Indiana University School of Medicine.

EARN CONTINUING EDUCATION CREDITS

This program has prior approval of the American Academy of Professional Coders for 1.5 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the Academy of the program, content or the program sponsor.

WHO SHOULD LISTEN?

HIM directors, coding managers, and staff; reimbursement managers and staff; patient financial services; billing managers and staff; compliance officers; cardiology department managers and techs; electrophysiology department managers and techs; documentation specialists.

Cardiology physician practices, cardiologists; electrophysiologists may also benefit from the program as a secondary audience.

Purchase a CD or audio archive of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.

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