In a recent Health Data Management article, Keystone Health Chief Operating Officer David Grant addressed the importance of ensuring clinician satisfaction with data integrity during EHR conversion. Legacy data missing from a new EHR can result in data gaps causing...
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Gold Star Ranking at RWJBarnabas Encompasses MPI and Data Integrity Work with Intellis
Dec 20, 2022 | Best Practices, Blog, HIT/HIM
In October 2022, Intellis’ New Jersey-based client RWJBarnabas received an unprecedented perfect score from Epic for its EHR implementation project, as Becker’s Hospital Review reported. The Gold Star 10 ranking, the highest level of recognition a health system can...
CDI Tips: Dementia
Nov 10, 2022 | Best Practices, CDI
Dementia: Will we need more queries? The short answer is yes! We need documentation of none, other, or a specified type of mood disorder. But here is the long answer: “Dementia The ICD-10-CM classifies dementia (categories F01, F02, and F03) on the basis of the...
Coding Tip: Lupus
May 9, 2022 | Best Practices, Coding Tips, Education & Training
When Lupus (unspecified) is documented in a record, there is no default code. Therefore, it is important to have providers document this condition as precisely as possible. For instance, document SLE (systemic lupus erythematosus) instead and add any complications...
Today’s Tip: Drug-induced Neuropathy
Mar 22, 2022 | Best Practices, Coding Tips, Education & Training
Drug-induced neuropathy (D62.0) is a diagnosis often missed by even the savviest and seasoned coders. It is sometimes seen in documentation as ‘CIPN’ (chemotherapy-induced peripheral neuropathy) and is a common side effect caused by antineoplastic agents. Treatment...
Coding Tip: Cachexia (R64)
Feb 18, 2022 | Best Practices, Coding Tips
Cachexia (R64) is also known as ‘wasting’ or ‘wasting syndrome’. It is a general state of weakness involving marked weight and muscle loss. Emaciated is another term that may be found in the documentation that also maps to code R64. These diagnoses are often missed...