The Documentation-Coding Connection

What to do now?

Review the Nov. 1, 2002, OPPS final rule (published in the Federal Register, Volume 67, No. 212, pp. 66,717-67,046).

Create a charge sheet for the ED to report procedures that are performed separately, (i.e., injections, infusion, CPR, intubation, wound repairs, fracture treatment, burn care, etc.) See example.

Assess the effectiveness of current charge capture and coding process and make changes if needed.

Keep the hospital’s chargemaster updated and have current chargemaster team meetings to help with this process.

Provide for an external audit of ED claims to get an "outside" perspective.