Reference no: EM133476988

Scenario

You are the new coding manager at Happyville Hospital. You are responsible for ensuring the healthcare organization's coding team is trained and can comprehend the official coding guidelines and NCCI edits critical to ensuring timely and accurate claim filing. That the coding team is engaged in CDI practices to ensure provider documentation supports indicators, procedures, diagnosis, and patient status. You are also responsible for supporting the coding team in coding by leveraging software, policies, procedures, and queries.

You have been tasked with reporting to the Happyville Hospital Compliance Officer the key areas the facility should utilize for auditing medical records and coding practices. And you must also provide the method to educate the coding team on any discrepancies found in one of the audits and how this educational method will work best for the coding team.

Next, in a project plan that:

Describes the three selected significant changes in coding guidance or compliance.

Identifies how the coding team will be trained on these three significant changes.

Recommends improvements to the Clinical Documentation Improvement (CDI) program and coding compliance, including:

Example of SMART Goals for the maintenance and monitoring of the CDI program and the schedule of audits.

Reporting structure provides feedback to all providers, with specific feedback from the CDI program per provider and generic/broad feedback per the provider group.

Education and training for the coding team to ensure compliance with official guidelines.