Articles for July 7, 2011

CDI Strategies - Volume 5, Issue 14

News: Special MLN Matters article discusses RAC DRG vulnerabilities

July 7, 2011
News, Quality & Regulatory

Inpatient hospital claims submitted to Medicare contain “a significant amount” of incorrect principal diagnoses, according to a Special MedLearn Matters article (SE1121) released June 23. Recovery Audit Contractors...Read More »
CDI Strategies - Volume 5, Issue 14

News: MAC contractor identifies E/M billing errors

July 7, 2011
News

Evaluation and Management (E/M) services accounted for $28 billion in Part B payments nationally from April 2009 to May 2010, ...Read More »
CDI Strategies - Volume 5, Issue 14

Tip: Query to clarify use of the term ’history’

July 7, 2011
Physician Queries, Clinical & Coding

Many cases exist in which CDI specialists need to query physicians to clarify the use of the term “history.” Consider the following situation in which a physician admits a patient with pyelonephritis. The past history states right lower lobe lung carcinoma proximal lesion. ...Read More »
CDI Strategies - Volume 5, Issue 14

Column: Defining 'failed' CDI programs

July 7, 2011
CDI Management

I previously started a conversation on CDI Talk entitled “Failed Programs,” hoping there might be someone willing to divulge an account of how and why their program “failed,” perhaps even how they were able to “save” or “reinvent” it. While the post generated quite a bit of conversation (there...Read More »
CDI Strategies - Volume 5, Issue 14

Q&A: Determine documentation difference between skin graft and debridement

July 7, 2011
Ask ACDIS

Q:  I have been trying to determine whether a skin graft includes debridement. Based on what I have read in the Official Guidelines for Coding and Reporting and ...Read More »