billing for new service lines should be given high priority to
identify and correct any issues as early as possible. Do you
have the internal expertise necessary to audit internally?
Can interdepartmental audits improve risk assessment
and increase audit efficiency?
How should you blend the use of random and focused audits to optimize risk assessment?
Assess your current staffing. Is there a gap bet ween expertise needed and what staff currently possess? Do supervisory job descriptions allow time for audit responsibilities
and staff education?
How can external audits be utilized to support internal auditing practices? What weaknesses were identified in your
staffing analysis that can be addressed with external audits?
What internal processes impact risk assessment? For example, evaluate all areas in the organization where diagnoses and procedures are captured.
Industry guidance will continue to evolve, and HIM professionals have a responsibility to continue the review of relevant
guidance and participate in the development of industry best
practices related to auditing. ¢
Mira Med. “CMS-HCC Risk Adjustment Auditing—A Necessary
Evil.” July 6, 2016. www.miramedgs.com/ealerts/569-cms-
Pinson, Richard D. and Cynthia L. Tang. Outpatient CDI
Pocket Guide: Focusing on HCCs. September 18, 2017. http://
Kathryn DeVault ( Kathy.firstname.lastname@example.org) is manager of HIM
consulting, and Natalie Sartori ( email@example.com) is corporate educator at UASI.
Inpatient Coding | Outpatient Coding | Professional Fee Coding
Long-term Engagements | On-Demand PRN Coverage hrgpros.com/coding
The May 2018 Coding Notes article titled “Coding Interventional Radiol-
ogy: Lower Extremity Area” included an incorrect example of how to code
selective catheter placements. The article originally stated: “For example,
a catheter is placed in the superficial femoral artery (SFA) (CPT 36247),
followed by a catheter placement in the anterior tibial artery. The anterior
tibial artery is also a third order catheter placement, but one cannot code
CPT 36247 more than once for each lower extremity. To capture the ad-
ditional work, code CPT 36247 and add-on code 36248.”
However, the catheterization of the anterior tibia is code 36247, not
36248. The SFA catheterization gets bundled when the anterior tibia is
catheterized. When a catheter is placed in the anterior tibia (36247), and
then the catheter is pulled back and another branch is catheterized—for
example, the posterior tibial artery—one would add 36248 for the ad-
ditional catheter placement. The Journal regrets the error.