PDGM-Ready Coding Services

How Do Fazzi’s Outsourced Coding Services Help You with PDGM?

We’ve been getting a lot of questions about how our Outsourced Coding Services help agencies with PDGM so we decided to share this information with all of you. Here goes:

  • Alerts! We’ve instituted a questionable encounter alert system into our standard coding process. That means that when an agency’s documentation and coding guidance call for a primary diagnosis code that does not fit into a PDGM clinical grouping, we will alert the agency prior to RAP. That way the agency can do some intervention with the referral source/intake/clinician to see if the documentation or plan of care need to be adjusted.
  • Reports! We’re providing our clients with primary diagnosis trend reporting for insight and training purposes. (New clients can receive these reports as soon as volume thresholds are met.)
  • Accuracy! We have a long standing proven track record of accuracy. In fact, while CMS is projecting that approximately 15% of episodes will not fit into a clinical grouping, our data shows percentages for current clients to be 7%, on average. We attribute this to the skill of our coders in finding the accurate and specific diagnosis in our clients’ documentation and also the close communication between our coders and our clients when clarification is needed.
  • Advice! Our coding services include consultation, and we are encouraging agencies to:
    • Work with their referral source and clinical teams to make sure the more specific condition to the symptom code is included on the referral. One example is a patient with osteoarthritis in their legs who is presenting with a gait abnormality. Instead of coding the gait abnormality, the agency should consider coding the osteoarthritis as it is the source of the gait abnormality.
    • Work with clinical teams to make sure that when their treatment is directed at a symptom they are documenting the original source of that symptom.
  • Reduced or Eliminated Costs of Recruiting, Training and Managing Staff: Efficiency and cost control will become even more important under PDGM. (We’ll take care of your back office while you take care of your patients.)

Want to learn more about how Fazzi’s Outsourced Coding can help you with PDGM? Contact us today!