Articles

CDI Journal - Volume 14, Issue 6

Always remember the patient: Departmental collaboration

November 1, 2020
ACDIS Guidance, Denials & Appeals

by Carolyn Riel
CDI teams have to work with other departments nearly daily in their line of work, be it the coding department, the clinical team, the quality department, or others. When it comes to denials management, this interdepartmental collaboration becomes even more...Read More »
CDI Journal - Volume 14, Issue 6

Guest column: Essential strategies for clinical validation

November 1, 2020
Denials & Appeals, Physician Queries

by Sydni Johnson, RN, BSN, CCDS, and Denice Piwowar, BSN, RN, CCDS
CDI professionals generally consider clinical validation queries to be the most challenging queries to generate and format. As CDI managers and educators, we’re often asked how to request supporting indicators of a...Read More »
CDI Journal - Volume 14, Issue 6

Note from the Associate Editorial Director: Wade in the waters of record defense

November 1, 2020
ACDIS Guidance, Denials & Appeals

by Melissa Varnavas
When I was a kid, my siblings would tease me. They’d tell me I was wrong, that I didn’t know what I was talking about. They’d say, “You’re in denial, and it ain’t just a river in Egypt.” Imagine a kid in pigtails sticking out her tongue and wagging her fingers...Read More »
CDI Journal - Volume 14, Issue 6

Managing priorities, monster spreadsheets: CDI leaders’ perspective on denials management

November 1, 2020
Leadership Council, Denials & Appeals

by Linnea Archibald
As the CDI profession has matured and expanded over the years, many CDI departments find themselves pulled down new avenues outside of the traditional chart review process. While not traditionally a role of CDI work, many have begun branching out into denials...Read More »
CDI Journal - Volume 14, Issue 6

Guest column: Using denial volumes as KPIs

November 1, 2020
Denials & Appeals, CDI Management

by Anneleah Williams-Bridges, MS, MBCA, RHIA, CCS, CCS-P, CCDS, RH-CBS, LIA
Until recently, many organizations have solely used their CDI resources to strengthen the capture of CCs/MCCs, Hierarchical Condition Categories, severity of illness/risk of mortality, and DRG validation....Read More »
CDI Journal - Volume 14, Issue 6

Podcast recap: A conversation with the OIG on severe malnutrition

November 1, 2020
ACDIS Guidance, Denials & Appeals

The following Q&A is an abbreviated transcript of the September 9, 2020 ACDIS Podcast. Note that the transcript has been lightly...Read More »
CDI Journal - Volume 14, Issue 6

Fight until the very end: Sepsis and malnutrition denials

November 1, 2020
Denials & Appeals, Clinical & Coding

by Carolyn Riel
Payers deny claims on a wide variety of grounds, but it’s no secret that certain diagnoses seem to be frequent denial targets. Each year, respondents to the...Read More »
CDI Journal - Volume 14, Issue 6

Guest column: CDI tips for top denied diagnoses

November 1, 2020
Denials & Appeals, Clinical & Coding

by Brian Simpson, MS, RRT, CCDS, CDIP, CCS, CRC
Despite not having a formal denials management team at Penn Highlands Healthcare, I am fortunate enough to assist our coding department when we receive a clinical validation denial. Since I am a respiratory therapist by background,...Read More »

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