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Forward20250730 CDI Mitigating Risk by Understanding 4 Key Documentation Concepts Lunch & Learn
Medovent Solutions/Bulwark Health completed a random 220 sample audit of Medicare Advantage records mid-year calendar year 2024 to validate hierarchical condition category (HCC) accuracy within the Outpatient Clinical Documentation Integrity department. Outpatient records across specialty and primary care were reviewed. Findings include HCC code accuracy capture 93%, missing HCC code capture 5.3%, and rebills for non-supported codes 0.85%. Opportunities to recapture historical HCCs, clarify clinical validation, gain specificity, and provide MEAT (monitor, assess, evaluate, treat) within encounter documentation was 12%.
From these results, the recommendation is that we continue to educate providers on correct documentation practices. This will hopefully lead to better documentation, more accurate billing and coding, and accurate documentation for various programs.
Learning Objectives
Upon completion of this activity, the participant should be able to:
- Identify the importance of MEAT criteria to support diagnoses for accurate coding
- Establish the difference between the clinical and coding worlds regarding the phrase, “history of”
- Outline the pitfalls and danger of utilizing the copy and paste functionality in your notes
- Review best practices for problem list maintenance with inclusion of pertinent details into your Assessment/Plan for each encounter
Accreditation: The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation: The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White designates this live activity for a maximum of 1.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABIM MOC PART 2: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
Available Credit
- 1.00 American Board of Internal Medicine (ABIM) MOC Part 2Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
- 1.00 AMA PRA Category 1 Credit™The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
- 1.00 Attendance