FILE | R | CODING AUDITS - Attachment

FBO DAILY ISSUE OF AUGUST 18, 2011 FBO #3554
DOCUMENT

R -- CODING AUDITS - Attachment

Notice Date: 8/16/2011
Notice Type: Attachment
NAICS: 541611 — Administrative Management and General Management Consulting Services
Contracting Office: Department of Veterans Affairs;Medical Center;Contracting (90C);2121 North Avenue;Grand Junction CO 81501
ZIP Code: 81501
Solicitation Number: VA25911RQ0179
Response Due: 8/23/2011
Archive Date: 9/2/2011
Point of Contact: Steven R. Gardner, Contracting Officer
E-Mail Address: 3-2800
Small Business Set-Aside: Service-Disabled Veteran-Owned Small Business
Description: This is a sources-sought notice only - and is an invitation for a "Request for Quotations" (RFQ). VISN19 Contracting, Rocky Mountain Network is searching for a small business that can demonstrate they have the technical experience and past performance data that supports their ability to perform the requirements illustrated below. This Contracting Officer is searching for one (1) disabled veterans small business, or two (2) veteran owned small business entities for market-competition. The Veterans Administration, VISN19 Contracting shall make the appropriate procurement decisions based upon the responses received from this notice. Procurement Type: This shall be for one (1) base year and four (4) option years, fixed price contract. The NAICS code, 541611 is applicable for this type requirement. The small business size standard for this code is $7.0M. Prospective businesses that are interested are reminded that in accordance with FAR 4.12, contractors shall complete electronic annual representations and certifications in conjunction with FAR 4.11 required registration the Central Contractors Registration (CCR) database prior to award of a contract. General Cheyenne VA Medical Center (CVAMC) is seeking a coding audit of outpatient and inpatient medical records. Medical record documentation will be accessed after the coding auditor receives access to the CVAMC computer system. Review of Outpatient and Documentation and coding The auditor will select a random sample of outpatient encounters consisting of twenty seven (20) encounters each for all coders. These encounters are to be selected randomly from the clinics designated in the table below. CODERCLINICProvider Notes VA CoderER Random VA CoderPrimary careRandom Coding CompanyPrimary careRandom VA CoderInpatientRandom VA CoderSurgeryRandom Coding CompanyER Random VA ProvidersPrimary CareRandom VA ProvidersSurgeryRandom VA ProvidersPrimary CareRandom Each medical encounter (Physician's orders, progress notes, consults, etc.) will be audited to ensure compliance in the following areas: 1.Appropriate documentation and coding of professional and/or institutional services. 2.Evaluation and Management Services (1995 E&M Standards) are supported by appropriate documentation. 3.Appropriate use of modifiers 4.Adherence to AHIMA standards of ethical coding, ICD-9-CM Guidelines for coding and reporting, and the Veteran's Administration Handbook for Coding Guidelines. 5.These records will be audited at the rate of ten (6-7) records per hour. Review of Outpatient Documentation and Coding: The auditor will review the ICD-9-CM diagnosis and CPT procedure on each encounter selected. a.An encounter is defined as: A professional contact on a specific date of service between a patient and a practitioner vested with primary responsibility for diagnosing, evaluating and/or treating the patient condition. b.The coding of the E&M code (using either 1995 and/or 1997 E&M standards) for that visit is a part of that visit and shall be evaluated as part of that encounter. c.Each ancillary service (Lab, X-Ray etc) ordered and reported on the same visit date is designated as a separate encounter. If available the auditor will review the following for medical record encounter selected: 1.Chief Complaint 2.Primary ICD-9-CM Diagnosis 3.Secondary ICD-9-CM Diagnosis (no more than three diagnoses) 4.Physician's Orders 5.Ancillary Services (Lab, X-ray, PT, OT, etc.) 6.Consultation 7.Progress Notes 8.Modifiers 9.Correct Coding Initiative (CCI) 10.Coding Summary or document that list the diagnosis and procedures codes selected by the coder or provider 11.Crossover of codes to UB92 or CMS 1500, if available In addition the auditor will assess the following: 1.Documentation and accuracy of ICD-9-CM/Modifiers present on the coding summary, UB 92 or CMS 1500. 2.Availability of crucial documentation to the coder at time of coding. 3.Adherence to AHIMA standards of ethical coding 4.Adherence to the Veteran's Administration Handbook for Coding Guidelines. The auditor will document the findings of the review of the medical record encounter on an excel spreadsheet (VA CBI Audit worksheet). Determination of accuracy of coding will be based on findings and reasons for change. In addition, the auditor may provide a summary of compliance issues and recommendations for proper disposition of such issues. The auditor will conduct a phone exit conference to review findings and to discuss coding issues with those you choose to attend. REVIEW OF INPATIENT DOCUMENTATION AND CODING Final Report
Web Link: FBO.gov Permalink
(https://www.fbo.gov/spg/VA/GJVAMC/VAMCCO80220/VA25911RQ0179/listing.html)
Document(s): Attachment; File Name: VA-259-11-RQ-0179 VA-259-11-RQ-0179.doc (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=234180&FileName=VA-259-11-RQ-0179-005.doc); Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=234180&FileName=VA-259-11-RQ-0179-005.doc; File Name: VA-259-11-RQ-0179 S-03 TEXT FOR FEDBIZOPPS NOTICE_02.DOC (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=234181&FileName=VA-259-11-RQ-0179-006.DOC); Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=234181&FileName=VA-259-11-RQ-0179-006.DOC; Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
Place of Performance: Address: U.S. Department of Veterans Affairs;Cheyenne VAMC;2360 East Pershing Blvd.;Cheyenne, Wyoming; Zip Code: 82001-5356
Record: SN02536163-W 20110818/110816235647-51298656f911264621ea3830526f440b (fbodaily.com)
Source: FedBizOpps Link to This Notice
(may not be valid after Archive Date)

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R -- CODING AUDITS - Attachment