Q: If the physician says “concerning for,” “considering,” “cannot be ruled out,” or “cannot be excluded” for a diagnosis is that considered an uncertain diagnosis? Can those terms be coded if the patient is being worked up? Are the terms “concerning for” and “considering” equal to the “...Read More »
Those following the episodic turns of the ICD-10-CM/PCS implementation saga witnessed another dramatic plot twist in the narrative this week when the American Medical Association (AMA) and CMS made a joint announcement essentially prioritizing physician ICD-10 education and allowing some...Read More »
CMS attempted, once again, to resolve ongoing patient status confusion—this time in its Outpatient Prospective Payment System (OPPS) proposed rule.Read More »
Want to know what the top 10 MS-DRGs are in the country? Just ask CMS, which released its third annual update to the Medicare hospital inpatient and outpatient charge data in June.Read More »
Q: I have been asked to build a query for a diagnosis of SIRS and/or sepsis for the following scenario: The patient was admitted for an infection urinary tract infection (UTI), pyelonephritis (PNA) and meets two SIRS criteria. The patient may be treated with oral or intravenous...Read More »
Just as you don’t talk about politics or religion at the dinner table, CDI and coding staff shouldn’t discuss their efforts’ effect on healthcare reimbursement.Read More »
