Gain a clearer understanding of severe malnutrition, its clinical criteria and CMS requirements for documentation, coding and billing, as well as issues that increase your vulnerability to adverse auditor action.
One billion dollars. That’s how much hospitals overbilled for severe malnutrition on inpatient claims during 2020, according to an Office of the Inspector General (OIG) audit. You probably know the rest of the story — ramped-up auditor scrutiny and aggressive efforts to recoup overpayments. Specifically, in late 2021 the OIG added severe malnutrition to its work plan, and audits of Medicaid claims were announced. In addition, severe malnutrition has become a target area, as a single major comorbidity or complication (MCC), on the Program for Payment Patterns Electronic Report (PEPPER).
Billing for severe malnutrition might seem like a highly risky proposition. But it doesn’t need to be this way. During this exclusive ICD10monitor webcast, Dr. Beth Wolf will clearly explain the clinical criteria for severe malnutrition, as well as CMS coding and billing requirements. Using the 2020 audit worksheets, she’ll also point out the documentation gaps that increase audit vulnerability. In addition, you’ll gain valuable insights into the addition of severe malnutrition to the PEPPER.
Severe malnutrition is often under-recognized in hospital patients, yet it’s a common end-stage manifestation of other serious chronic diseases and a significant contributor to morbidity and mortality. By following Dr. Wolf’s guidance, you can improve the accuracy of your severe malnutrition diagnosis coding and fill crucial gaps in your supporting documentation. Ultimately, you’ll be better positioned to consistently capture the full, appropriate payment and reduce the threat of penalties and paybacks.
Coders, clinical documentation integrity (CDI) specialists, health information management (HIM) professionals, auditors and physician advisors.
Only one login is allowed per webcast purchased. Discounted pricing for additional registrants is available.