What kind of coding quality review should be performed if the CFO suspects coding errors due to a drop in the Medicare case-mix index?

The best approach in this situation is a focused audit. A focused audit allows for a detailed examination of specific areas of concern—in this case, the coding practices that may have led to a drop in the Medicare case-mix index, which can affect reimbursement levels. By narrowing the review to specific areas, the auditor can efficiently identify any patterns of errors or inconsistencies, providing insights that are directly aligned with the CFO's suspicions.

This targeted approach is particularly effective when there is a specific symptom of a broader issue, such as the decrease in the case-mix index. Unlike a comprehensive audit, which is more extensive and time-consuming, a focused audit addresses the immediate concerns and potential coding inaccuracies that could be impacting financial performance.

In contrast, random sampling audits could spread the focus too widely, potentially missing critical issues related to specific cases that the CFO is concerned about. A comprehensive audit would be more thorough but may not provide the rapid feedback the CFO is seeking regarding specific coding concerns. A post-payment audit would assess claims already submitted and paid but would not help in identifying and resolving the current coding issues impacting the case-mix index.