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Principal Diagnosis Selection: Ensure Compliance with Official Coding Guidelines

Gain an understanding of practical application of principal diagnosis selection while incorporating justifiable procedures and services.

In this material, we will examine diagnosis versus procedures with regard to determining what should be coded, and how the coder has to identify two main elements: the diagnosis and the procedure. There is much more involved in the coding process than just looking up a term and assigning the code next to that term. We will explain the guidelines as some are complicated and complex. The procedure is "what is done," and the diagnosis is "why it is done." We will focus on the why. If a patient has a tonsillectomy because of acute tonsillitis, then the coder recognizes that "what is done" is the tonsillectomy, and "why it is done" refers to tonsillitis. There must be at least one diagnosis for each procedure performed, as payers require proof that services are medically necessary. The diagnosis is usually the determining factor to justify procedures and various services. We will discuss what should be coded and the rules that come into play for coders/billers to follow, and translate the rules and ease the complexity in order to be compliant.

Runtime: 95 minutes
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Why Lorman?

Over 32 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Agenda

Coding Accuracy

  • There Is a Rhyme and Reason of Selecting a Principal Diagnosis
  • Why Does Proper Sequencing Matter?
  • Strategies That You Should Consider

Document, Document and Document Some More

  • Painting an Accurate Picture of What Is Happening With the Patient
  • The Devil Being in the Detail of a Note

Guidelines and Instruction

  • Rules for Coding
  • Introducing Hcc and What That Means
  • Defensive Coding and Medical Necessity
  • Who Is at Risk?
  • Medicare and the List of Unacceptable Primary Diagnosis Codes
  • Is There a Document to Reference?
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Why Lorman?

Over 32 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Credits

OnDemand Webinar

This course was last revised on April 30, 2019.

Call 1-866-352-9540 for further credit information.

  • AHIMA 1.5 including Clinical Data Management 1.5
     
  • This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
     

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

Audio & Reference Manual

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

MP3 Download

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

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More Program Information

Why Lorman?

Over 32 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Faculty

Rhonda Granja, B.S., CMC, CMA, CPC, CMOM

Rhonda Granja, B.S., CMC, CMA, CPC, CMOM

Rhonda Granja Consulting

  • Independent medical consultant and PMI faculty member
  • Speaker at the 2013-2015 PMI National Conference
  • Speaker at the 2014 AMBA National Conference
  • McVey Seminar leader
  • Panel speaker for The Coding Leader
  • Panel speaker at Compliance World
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Why Lorman?

Over 32 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

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Product ID: 404244
Published 2019
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