Your hospital has a policy in place that requires “death charts”—that is, charts of patients who died in the hospital, to be reviewed by compliance staff immediately.

Chapter 6

Critical Thinking Questions

Your hospital has a policy in place that requires “death charts”—that is, charts of patients who died in the hospital, to be reviewed by compliance staff immediately. In order to comply with that policy, a procedure was developed and implemented years ago that required the record to be hand-delivered to the compliance department as soon as the patient expired. Compliance generally forwards the record to the HIM department within three days of death. That procedure is still in place; however, the bill hold period has dropped from seven days to three days. Even though your patient records are largely electronic, the physician progress notes and some other documentation is still in paper form. What are the issues that arise in this scenario? How might you address those issues?

You have just been made aware that there are over $1 million in DNFB charges pending because the interventional radiology staff has not entered their charges. The CPT code attached in the chargemaster to the charges for that area is required for billing. Upon investigation, you find that the technician who usually enters these charges has been out sick for several days and no-one else knows how to code the accounts. Your staff informs you that charge posting in this area is chronically late, although generally not more than a day past bill hold. What is the issue here and what can you do about it?

Go to the OIG website at http://oig.hhs.gov (Links to an external site.). Under Reports and Publications, select Workplan. Browse through the section on hospitals. For issues that concern billing and coding, what concerns do you have and how will you address those concerns?