By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    photo of hands with blue veins
    8 Proven Tips on Finding Difficult Veins
    November 12, 2021
    tips for getting over the pandemic blues
    4 Proven Ways to Get Over the Pandemic Blues
    February 22, 2022
    medical industry innovations
    How is CNC Machining Transforming the Medical Industry?
    June 2, 2022
    Latest News
    5 Steps to a Promising Career as a Healthcare Administrator
    July 31, 2025
    Why Custom Telemedicine Apps Outperform Off‑the‑Shelf Solutions
    July 20, 2025
    How Probate Planning Shapes the Future of Your Estate and Family Care
    July 17, 2025
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    comparative negligence
    Not Knowing About Comparative Negligence Can Worsen Your Medical Debt
    April 12, 2023
    racial disparities in healthcare
    Why We Need to Address Racial Disparities in Maternal Health Care
    August 26, 2021
    Enhancing Pharmaceutical Patient Compliance & Drug Efficacy
    February 12, 2024
    Latest News
    How IT and Marketing Teams Can Collaborate to Protect Patient Trust
    July 17, 2025
    How Health Choices and Legal Actions Intersect After an Injury
    July 17, 2025
    How communities and healthcare providers can address slip and fall injuries with legal awareness
    July 17, 2025
    Let Your Lawyer Handle the Work Before You Pay Medical Costs
    July 6, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Top at Risk DRG’s in the Post ICD-10 Era & How to Proactively Address Coding Challenges
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Finance > Top at Risk DRG’s in the Post ICD-10 Era & How to Proactively Address Coding Challenges
FinanceHealth Reform

Top at Risk DRG’s in the Post ICD-10 Era & How to Proactively Address Coding Challenges

philcsolomon
philcsolomon
Share
4 Min Read
MiraMed webinar
SHARE

 

ICD-10 is expected to be fraught with significant challenges to coding quality because:

 

ICD-10 is expected to be fraught with significant challenges to coding quality because:

More Read

Dr Paul Rosen
What Would Empathy-Based Healthcare Look Like?
Person-Centered HealthCare: Three Benefits of Improving the Patient Experience
Fed Gov’t Approves Covert Study of Access to Primary Care
How Health Innovators Can Foster Patient Empowerment
Why I Don’t Adhere to Evidence-Based Medical Care
  • Dealing with a very new coding and documentation paradigm
  • The predictability in coding due to an unpredictable financial environment
  • Limited experience in DRG analysis and claims processing best practices

The key to working in the new ICD-10 system requires preparation to make sure that physician documentation clearly reflects the approach of the procedure. Coders must also be sure to capture the correct root operation. All of this information is a key to determining what drives the proper MS-DRG and the most reimbursement possible.

How your organization predicts cost distribution from the new Post ICD-10 environment creates challenges for budgeting, contracting monitoring utilization and a host of other important activities.

There has been plenty of discussions and testing from CMS about transition coding from ICD-9 to ICD-10. With small sample sizes, it is yet to be determined the overall result for each provider organization.

Even with the Medicare 1-year grace period for claims bearing the ICD-10 diagnostic codes that go into effect October 1 there will still be reimbursement issues. While CMS won’t reject payment simply because the ICD-10 code submitted isn’t specific enough, it will not pay the largest amount unless it includes the correct specificity.

Also, the white elephant in the room could become the biggest challenge. It is how commercial payers will respond and how their policies will slow payment and negatively affect reimbursement and revenue.

There will be plenty gray areas providers will have to navigate through, and I suspect questions will continue to come up for the foreseeable future.

MiraMed webinarTo help providers with the knowledge necessary to reduce the risk of the Post ICD-10 transition, I invite you to join an educational webinar titled: Top at Risk DRG’s in the Post ICD-10 Era & How to Proactively Address Coding Challenges. Register now, space is limited: https://attendee.gotowebinar.com/register/2795847332489274113

The host: Lyman Sornberger. Mr. Sornberger is a 29-year healthcare veteran who led revenue cycle activities for The Cleveland Clinic and UPMC and consults with the largest health systems in the country.

In this webinar, you will learn how to address Post ICD-10 coding challenges by:

  • Identifying the top DRG’s and understanding the cost and how to decrease poor reimbursement results
  • Identifying specific documentation issues and associated risk areas
  • Understanding the costs to rework claims, how to reduce coding errors and cut expenses
  • Tracking performance through executive & operational dashboards
  • Identifying total costs and financial risks for ICD-10 coding
  • Understanding specific DRG’s at-risk and mitigation strategies
  • How to pick the right onshore/offshore coding outsourcing partner
  • What to expect from Post ICD-10 coding in 2015, 2016 & 2017

For more information, contact: Phil Solomon – Vice President of Global Services | phil.solomon@miramedgs.com | 404-849-8065

__________________

Phil C. Solomon is the publisher of Revenue Cycle News, a healthcare business information blog. He serves as the Vice President of Global Services for MiraMed, a global healthcare Business Processing Outsourcing services company. Phil has 25 years of experience in healthcare as an industry thought leader, strategist, solution provider, author and featured speaker. In this blog, you will read about important industry updates, strategies for
improving financial performance, and commentary that challenges the status quo. 

The post Top at Risk DRG’s in the Post ICD-10 Era & How to Proactively Address Coding Challenges appeared first on REVENUE CYCLE NEWS.

Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

5 Steps to a Promising Career as a Healthcare Administrator
5 Steps to a Promising Career as a Healthcare Administrator
Health
July 31, 2025
holistic dental
Holistic Dentist Services Are Natural and Safe
Dental health Specialties
July 28, 2025
botox certification
Help Improve People’s Skin Health Via Botox Certification
Skin Specialties
July 22, 2025
Telemedicine Apps
Why Custom Telemedicine Apps Outperform Off‑the‑Shelf Solutions
Health
July 20, 2025

You Might also Like

echocardiographic
DiagnosticsFinanceHealth ReformPolicy & LawSpecialties

Echocardiographic in General Population Not Effective in Reducing Death/Disease

August 12, 2013
health startup
BusinessFinance

Want to Land a Spot in That Startup Accelerator? Smart Tips from Health Startup Founders

November 16, 2013
icd-10 and HIPAA
FinanceHospital AdministrationMedical RecordsPublic Health

Improve Document Security in the Face of ICD-10: A HIPAA Checklist

March 29, 2014

Pay-for-Performance: An Overview

January 20, 2011
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?