Outpatient CDI Pocket Guide: Focusing on HCCs

Pinson & Tang

$100.00$179.00

The definitive reference guide for outpatient CDI, the Outpatient CDI Pocket Guide: Focusing on HCCs features an easy to understand approach, boiling HCCs down to a few basic principles and provides the key references to have ‘at your fingertips’ when working to ensure accurate, complete, and defensible documentation in the outpatient setting.

Offered as a downloadable e-book for laptop or tablet, or the classic spiral-bound format sized to literally “fit in your pocket.” Choose the version right for you in the dropdown menu below.

***Special Pricing! Purchase both the Outpatient CDI Pocket Guide and the Outpatient CDI Pocket Guide eBook for $179 — a savings of 32% off the price of both items sold separately!***

CEUs:     N/A - AHIMA      N/A - AAPC
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The definitive reference guide for outpatient CDI, the Outpatient CDI Pocket Guide: Focusing on HCCs features an easy to understand approach, boiling HCCs down to a few basic principles and provides the key references to have ‘at your fingertips’ when working to ensure accurate, complete, and defensible documentation in the outpatient setting.

Authors Richard Pinson and Cynthia Tang explain how HCCs affect both providers and payers and clarify the chief considerations in outpatient reimbursement, documentation, and coding guidelines. Outpatient CDI Pocket Guide: Focusing on HCCs is appropriate for Clinical Documentation Integrity specialists, coders, risk adjustment auditors, nurses, or physicians.

Outpatient CDI Pocket Guide: Focusing on HCCs is your reference guide to steer you to documentation success for outpatient CDI and HCCs.

  • Focus on areas of greatest impact as you expand your CDI program to the outpatient setting
  • Improve capture of HCC diagnoses that will optimize hospital and physician risk adjustments for value-based payments
  • Increase risk adjustment factor scores for Medicare Advantage health plans
  • Ensure your organization’s outpatient coding practices are compliant and meet clinical validation and documentation requirements.

The eBook is provided in both .epub and .mobi format for compatibility across e-readers for Android, Apple, and Amazon Kindle devices.

CDI Pocket Guides are sent via USPS Priority mail.  Allow 2-3 days for delivery. Price includes shipping. 

Buy the Outpatient CDI Pocket Guide: Focusing on HCCs together with the CDI Pocket Guide and SAVE! Purchase here.

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Contents: Outpatient CDI Pocket Guide: focusing on HCCs

OUTPATIENT CDI
OUTPATIENT VS. INPATIENT PAYMENT METHODOLOGIES

  • Hospital outpatient payment
  • Physician payment

HCCS AND RISK ADJUSTMENT

  • Medicare vs. Medicare Advantage
  • Who uses HCCs, and How?
  • HCC Methodology
  • CMS-HCC Payment
  • Methodology for MA Plans
    • Hierarchies
    • Disease interactions
  • Diagnosis Sources
  • HCC impact on MA Plans
  • HCC impact on Providers
  • CMS-HCC vs. HHS-HCC

CMS PAY FOR PERFORMANCE PROGRAMS

  • Hospital Pay for Performance Programs
    • Hospital Value-Based Purchasing
    • Hospital Readmissions Reduction (HRRP)
    • Hospital-Acquired Condition Reduction (HACRP)
  • Physician Pay for Performance Programs
    • Accountable Care Organizations (ACO)
    • Merit-Based Incentive Payment System (MIPS)

EXPANDING YOUR CDI PROGRAM

  • HCCs in the inpatient setting
  • Payer denials and appeals
  • Physician office practice
  • Emergency department
  • Observation services

GUIDELINES
OUTPATIENT DIAGNOSTIC CODING GUIDELINES
COMPLICATIONS OF CARE
OUTPATIENT DOCUMENTATION REQUIREMENTS
PHYSICIAN QUERIES
EVALUATION & MANAGEMENT (E/M) GUIDELINES

  • New E/M Payment Rules for 2021

REGULATORY COMPLIANCE

KEY DIAGNOSES
AMPUTATION STATUS
ANGINA
AORTIC ATHEROSCLEROSIS, ANEURYSM, ECTASIA
ARTIFICIAL OPENINGS
CARDIAC DYSRHYTHMIA
CHRONIC KIDNEY DISEASE
COPD/BRONCHITIS/ASTHMA
DEEP VEIN THROMBOSIS
DEMENTIA
DEPRESSION AND BIPOLAR DISORDER
DIABETES MELLITUS
DIABETIC COMPLICATIONS

  • Arthropathy
  • Circulatory disease
  • Hyperglycemia
  • Hypoglycemia
  • Hyperlipidemia
  • Nephropathy
  • Neuropathy
  • Opthalmic
  • Oral complications
  • Osteomyelitis
  • Skin complications

HEART FAILURE
HEPATITIS
HIV/AIDS
MALNUTRITION
NEOPLASMS
OBESITY AND BMI
PARALYSIS (PLEGIA AND PARESIS)
PNEUMONIA
PULMONARY HYPERTENSION & HEART DISEASE
RESPIRATORY FAILURE
SKIN ULCERS
SUBSTANCE USE, ABUSE, DEPENDENCE
PROVIDER HCC FAVORITES LIST

HCCS
OVERVIEW
CMS-HCCS, V24.0
HCC COMMON DIAGNOSIS LIST
COMMON DIAGNOSIS LIST BY HCC

Dr. Richard Pinson, MD, FACP, CCS
Dr. Richard Pinson is a physician, educator, administrator, and healthcare consultant. He practiced Internal Medicine and Emergency Medicine in Tennessee for over 20 years having board certification in both. Dr. Pinson is a Fellow of the American College of Physicians and former Assistant Professor of Clinical Medicine at Vanderbilt, and has assisted hospitals as a physician consultant for the past ten years.

His personal understanding of the mindset of both doctors and managers allows him a unique vantage point from which to promote cooperation between physicians, hospital staff, and administrators toward achieving beneficial and practical changes.

 

Cynthia Tang, RHIA, CCS
Cynthia brings over 30 years of experience in health information management, coding and clinical documentation, and clinical resource management. For the past twenty years she has traveled to hospitals throughout the country to assess their processes for managing health information and clinical documentation and to provide her much-sought after expertise in redesigning operations to promote better patient care and hospital financial health.

Her focus is on workflow design and improving clinical documentation with a view to optimizing reimbursement, ensuring compliance, and improving quality and pay for performance measures.

 

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