Clinical validation denials

March 1, 2023
Denials & Appeals

Today’s guest is Laura McLaughlin, BSN, RN, CCDS, a CDI specialist at Froedtert Health in Milwaukee, Wisconsin. Today’s show is part of the “Conversations with Karla” series. In every episode of this series, ACDIS Editor and Product Coordinator Karla Accorto will be joined by a guest who’s behind one of our most popular and exciting ACDIS educational offerings to share their expertise.

Our intro and outro music for the ACDIS Podcast is “medianoche” by Dee Yan-Kay and our ad music is “Take Me Higher” by Jahzzar, both obtained from the Free Music Archive.

Have questions about today’s show or ideas for a future episode? Contact the ACDIS team at info@acdis.org.

CEU info:

Each ACDIS Podcast episode now offers 0.5 ACDIS CEUs which can be used toward recertifying your CCDS or CCDS-O credential for those who listen to the show in the first two days from the time of publication.

To receive your 0.5 CEUs, go to the show page on acdis.org, by clicking on the “ACDIS Podcast” link located under the “Resources” tab. To take the evaluation, click the most recent episode from the list on the podcast homepage, view the podcast recording at the bottom of that show page, and click the live link at the very end after the music has ended. Your certificate will be automatically emailed to you upon submitting the brief evaluation.

The cut-off for today’s episode CEU is Friday, March 3, at 11:00 p.m. eastern. After that point, the CEU period will close, and you will not be eligible for the 0.5 CEUs for this week’s episode.

Today’s sponsor:

Today’s show is brought to you by ACDIS PRO. ACDIS PRO delivers all the decision-making information necessary to conduct medical record reviews in an easy-to-reference online app. CDI specialists rely on ACDIS PRO as their go-to resource for compliant and effective clinical indicators for physician queries.

Quickly look up the latest clinical definitions, diagnostic criteria, treatment protocols, coding considerations, and critical thinking tips for over 90 clinical conditions. Search and sort, take notes, and bookmark tips within your own customizable user interface. Benefit from regular automated updates to query, coding, and documentation changes as they happen so that your reference is never out of date.

And now, ACDIS PRO provides the information CDI specialists need to understand which codes trigger a patient safety indicator (PSI) in the PSI 90 composite and which exclude the encounter from reporting. When reviewing records that could trigger a PSI in PSI 90, CDI specialists want to ensure that all information is captured correctly. ACDIS PRO provides users with access to the information needed to properly report these PSIs and to identify exclusions that would remove an encounter from a PSI, resulting in a positive impact on their organization’s reimbursement rates.

Learn more by clicking here. (http://ow.ly/oIWr50N4Zhq)  

ACDIS update: