No matter how thorough the documentation, no matter how precise the coding, denials still haunt the halls of most facilities. While many facilities have a denials department handling all appeals, others incorporate physician advisors and CDI professionals into the equation. Differing...Read More »
Intensive care units are expensive, invasive, and supposed to be reserved for the sickest hospital patients, but more than half the time, they're not needed, according to research from LA BioMed and UCLA,...Read More »
By Janie L. Brown, RN
Denied. It’s a word that no one wants to hear in any context. In healthcare, it’s a heavily weighted word. It means that, in spite of our best efforts to provide excellent care to our patients and to document that care appropriately, we are not receiving...Read More »
The 2017 updates to ICD-10-CM included many additions to the digestive system diagnoses, especially with codes for pancreatitis and intestinal infections. The codes largely focus on the lower gastrointestinal (GI) tract, according to an article published in...Read More »
Because of payers’ propensity for denials, facilities need to have a process in place for managing denials’ root causes on the front end and appealing them on the back end. This, however, can involve a lot of hard work and headaches.
Last week I had the wonderful opportunity to attend the joint Tennessee Health Information Management Association/Tennessee ACDIS local chapter meeting. The Tennessee Hospital Association kindly hosted the all-day event at their wonderful facility in Brentwood. The theme of the meeting was ...Read More »
By Rachel Strom, RN
Yes, I’ll admit it, I used to be one of those people, I am a former Medicare Administrative Contractor (MAC) reviewer. Before finding a great fit in on a CDI dream team (or so I’d like to think we are), I worked as a Medical Review Examiner for a MAC contractor...Read More »
