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the second picture is the continuation of the first picture. tgey are all question to the paragraph. The Biiling Department has received a denial of
the second picture is the continuation of the first picture. tgey are all question to the paragraph.
The Biiling Department has received a denial of payment for an inpatient hospitalization that had an extended length of stay of 10 days. The patient received a number of radiological intervinntions and treatments for a diagnosis that had a typical length of stay of 5 days. The provider is being asked to explain the lengthy and costhy hospitalization in appeal of the denial. Of note, the hospital is in the process of transitioning to a fual EhiR. Upon review of the patient's electronic medical record, it is noted that there are a number of exacerbated chronic cenditions that were present on admission and were treated during the hospitalization. The provider explained that the chronic conditions delayed the healing process. Coding was engaged to review the electronic documentation and the paper charts to ensure alf possible diagnoses and procedures were coded. Instructions: State your interpretation in response to the following questions. Provide support for your rationale based on lesson content. 1. Determine a possible explanation for the denial of charges based on the extended length of stay? 2. Was this a fallure on the part of the provider to fully document the patient's conditions and treatment-why or why not? 3. Was this a failure on the part of coding to read the entire patient record when assigning the codes-why or why not? 4. Was there a failure on the part of billing to ensure that the claim was clean prior to submitting for payment-why or why not? The Biling Department has received a denial of payment for an inpatient hospitalization that had an extended length of stay of 10 days. The patient received a number of radiological interventions and treatments for a diagnosis that had a tyifical leneth of stay of 5 days. The provider is being asked to explain the lengtiny and costly hospitalization in appeal of the denial, Of note, the hospital is in the process of transtioning to a full EHA. Upon review of the patient's electronic medical record, it is noted that there are a number of exacerbated chronic contitions that were present on admission and were treated during the hospitalization. The provider explained that the chronic coryditions delayed the healing process. Coding was engaged to review the electronic documentation and the paper charts to ensure all possible diagnoses and procedures were coded. Instructions: State your interpretation in response to the following questions. Provide support for your rationale based on lesson content. 1. Determine a possible explanation for the denial of charges based on the extended tength of stay? 2. Was this a fallure on the part of the provider to fully document the patient's conditions and treatment - why or why not? 3. Was this a failure on the part of coding to read the entire patient record when assigning the codes-why or why not? 4. Was there a fallure on the part of billing to ensure that the claim was clean prior to submitting for payment-why or why not Step by Step Solution
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