FEATURES 7 Concurrent coding 12 CMS-HCC version 23 released 17 Mortality reviews and publicly reported quality scores 25 Submit questions to Coding...Read More »
by Melissa Varnavas
It’s that time of the year again: time to pull down the tome that is the inpatient prospective payment system (IPPS) final rule and mine its pages for changes relevant to daily CDI reviews. While intimidating at more than 600 pages, the IPPS rule can be broken...Read More »
By Sam Antonios, MD, MMM, FACP, SFHM, CPE, CCDS
Consider the story of a patient—say, a pneumonia patient—whose treatment cost a lot of money. The hospital’s reimbursement for that care, however, was less than the cost of providing it. Now say someone looked at that case and how...Read More »
Much like concurrent CDI reviews, the concurrent coding process necessitates that the coding professional follow the chart throughout the patient’s admission and code it at intervals. The hope is that this process limits the number of clarifications needed after discharge, allowing the...Read More »
Q: What is difference between the severity of illness (SOI)/risk of mortality (ROM) in the APR-DRG arena? For example, DRG 280 with APR 190, 4/4, and the individual code SOI/ROM.
Let’s say you have a patient with a ST-...Read More »
Like all reporting structures, CMS updates its Hierarchical Condition Category (HCC) list each year. Recently, version 23 was released, and it contains some notable additions that CDI professionals—whether inpatient or outpatient—should be aware of.Read More »
by Richard Pinson, MD, FACP, CCS and Cynthia Tang, RHIA, CCS
The clinical world now has a new set of criteria for malnutrition, thanks to representatives from the American Society for Parenteral and Enteral Nutrition (ASPEN), the European Society for Clinical Nutrition and...Read More »
When a patient comes into the hospital and, despite the medical staff’s best efforts, dies, the documentation in the record should accurately reflect how truly sick the patient was. Unfortunately, the record frequently depicts a more-or-less healthy patient who came into the hospital and then...Read More »
