Oasis and Coding Review or as we refer to ourselves, The Coders, is a new company that was created by nurses and coders just like you to help you get the work done and get paid every penny you deserve and not one cent more. When your competitors are worried about missing payroll or over-payments, we have your back.
Most agencies do not deliberately upcode and if you believe that the best code for a patient is the one that pays the most, you probably don’t belong here. If you are one of the good guys – and we believe most agencies are good – you have two choices. You can invest in professional coders or farm your work out to those of us who know ICD-9 Coding and OASIS inside out. We can’t tell you what the best solution is for your agency but we can help you make the choice.
In addition to traditional ICD-9 coding, we also provide the following services:
- Carefully crafted care plans tailored to your patients based upon your assessments.
- OASIS Review
- Formal and informal education
- Complete operational assessments including billing and clinical procedures
The Coders work closely with billing and consulting companies that share mutual ownership. Whether you just need help getting solid, useful care plans out the door with proper coding or you need on site assistance during an audit or survey, we can provide the help you need. If you need an objective assessment of your billing process or even someone to take over billing for you, we can hook you up.
We believe in home health. We have lived through the dark ages of IPS (1998), survived PPS and the subsequent refinements and watched friends and clients thrive under each new change or fall by the wayside. We have no special gifts other than still being here after so many near misses. We are not magical superheroes. We are hard-working members of the home health industry just like you. Any consultant can tell you what you are doing wrong and where your problems are. We roll up our sleeves and work alongside you and show you and your staff how to do it better.
If you’re ready for a break from worrying and you want your nurses to get back to taking care of patients, we can help.
considering out sourcing coding. question how does your company handle the coder actually entering the codes into what ever system you have. I have heard different opinions on this. one that only the RN can actually enter the codes into the oasis. Other is that the coding people who u outsource to can review the oasis and other documentation and code off of that?
That’s a good question and frankly, it depends on the system.
In some systems where you cannot move forward until codes are entered, we simply read everything and write an email for the nurse on site to enter the codes. Outsourcing the task of coding is fine. You cannot outsource the responsibility. Any offsite coder makes assumptions about what is in the chart. A lot of codes come with caveats. Last night I reviewed a chart that mentioned a foley catheter in one place and there was no mention of it in any notes. Obviously Foley Catheter Related changes should be coded IF THERE IS A FOLEY. In systems that do not allow changes without ‘saving them’ we don’t go there.
Other systems will allow us a rough draft. In those systems, we enter the codes and send a brief note to the nurse asking for clarification if needed. For instance, we may see medications for glaucoma and poor vision in the OASIS assessment but we cannot code low vision unless there is validation from the physician. In a system that allows us to add the code, we will do so but tell the nurse to remove it if no such verification exists.
We code differently from many companies. We do ask that the nurse add diagnoses and codes, if known, regarding what is wrong with the patient. However, the very reason agencies outsource coding is because they are not coding experts. We do our best coding for agencies that write very good summaries. We find ourself looking at visit note narratives to see if the codes are supported in the documentation. We look at the OASIS for apparent discrepancies. Most OASIS errors result from the nurse not understanding the questions. We seldom ‘change’ OASIS in the system, however. Our changes are often overlooked and surprisingly, may be wrong. Instead, we send a note to the nurse stating something like, ‘You stated that the patient can’t leave the house because of severe shortness of breath and albuterol is in the med list, yet you said the patient could walk more than 20 feet without SOB. Will you please verify your answer before submitting OASIS data. And the nurse may see our point or she may have a patient with severe asthma who breathes just fine but can have devastating attacks when exposed to certain allergens outdoors. Our point is that if it questionable to us, then it is probably questionable to anyone reviewing the chart for payment. So, if the asthma attack scenario is the case, we recommend that she document that in her narrative or elsewhere to prevent confusion and apparent discrepancies.
I know this is more than you asked for but there is a way to use consultants and coders to expedite and ensure correct documentation. The system used dictates how we do it. No matter what any coding company tells you, you cannot off load the responsibility to a third party. There is so much to coding that I highly recommend that everyone have a contract with a coding company until they have two certified coders on staff. Even if you have a certified coder, the work is too important to delay when the coder goes on vacation. That’s where the back up comes in.
Obviously, we are the best coders in the world but even you choose to use other companies, remember, the nurse who does the OASIS is responsible for every bit of information on the assessment. Read the OASIS manual on collaboration – you’ll find it with therapy questions.