Medical coding 1 unit 5 assignment

Coding Management And Compliance Unit 5 Assignment 1-2

Assignment Purpose:

Valid medical necessity

Assignment Description

Step One: From the textbook, Case Studies in Health Information Management, follow the instructions to complete case 2-41 Medical Necessity

Step Two: Create a 1-page APA formatted paper which explains how medical necessity is determined and identify processes that can be put into place to ensure medical necessity is met. (HINT: Think about LCD’s, NCD’s, and CCI edits). One reference is required.

Step Three: Submit your response to the case study and the 1-page paper for grading

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CASE 2-30: Case Mix Index (CMI) Investigation

The CFO just called. He was supposed to have asked you to get him the CMI for 2010, 2011, and 2012 a month ago. He has just realized that he never asked you for the data. He must have it for the board of directors meeting that takes place in 3 hours, but he actually needs the information in an hour so that it can be copied and placed in the packet for the board members. He needs you to create a bar graph to show the trending. He also needs you to provide an analysis of the trends so that he can report it to the board.

1. Use the information in Table 2-16 to make a line graph of the CMI for calendar years 2010, 2011, and 2012.

ble 2-16: Case Mix Index (CMI) for Years 2010, 2011, and 2012 by Month

CMI by Month

Years 2010, 2011, and 2012

Month Year

2010 2011 2012

January 1.4321 1.3276 1.3756

February 1.3215 1.2535 1.4544

March 1.2487 1.2478 1.2489

April 1.5789 2.2435 1.2570

May 1.5789 1.5248 1.5278

June 1.5321 1.4245 1.5741

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8/10/2018 Vitalsource: Case Studies for Health Information Management

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2. What trends can you identify? 3. Can you identify any cause for concern? 4. What investigation would you want to conduct?

July 1.2635 1.2857 1.2576

August 1.5227 1.4456 1.5700

September 1.4568 1.2357 1.2768

October 1.2748 1.2575 1.2578

November 1.3578 1.3574 1.4456

December 1.2357 1.6574 1.5788

Annual