A number of inpatient prospective payment system changes in recent years, due primarily to the Affordable Care Act, have allowed CMS to adjust healthcare reimbursement based on quality metrics and data. But some providers are unaware that many quality scores for themselves and hospitals are...Read More »
Nearly 60% of patients say that online reviews matter to them when choosing a physician, according to a study conducted by the Journal of the American Medical Association (JAMA) in 2014. However, the scope and usefulness of those online reviews are limited, according to a study conducted by JAMA...Read More »
Mortality reviews are becoming more prevalent in the CDI world. But what do they really mean for CDI specialists? Some organizations have mortality review committees, but such reviews don’t always fall under CDI; they could be managed by the quality...Read More »
These last several months have seen a dizzying array of changes, controversies, and regulations along with an equally dizzying array of discussion, advice, and opinions. Some are straightforward progress, while some result in confusing and sometimes...Read More »
by James S. Kennedy, MD, CCS, CDIP, CCDS
Bronchopulmonary infections, such as acute bronchitis and pneumonia, represent frequent reasons for physician and facility encounters, resulting in ICD-10-CM code assignments that factor greatly in severity and risk adjustment inherent to...Read More »
by Joel Moorhead, MD, PhD, CPC
This article is about bringing the patient to the center of clinical validation. A patient with an “atypical” presentation, by definition, may have the disease but might not meet “typical” criteria for diagnosis.Read More »
With the criteria and definition of sepsis in flux, CDI specialists’ involvement in clarifying matters continues to grow. While the Surviving Sepsis Campaign seems to endorse the Sepsis-3 definition, CMS still uses the Sepsis-1 definition. The ACDIS Advisory Board sought to explore the confusion...Read More »
Q: According to a denial letter, acute metabolic encephalopathy secondary to any disease (which it obviously always is) codes to G94, other disorders of brain in diseases classified elsewhere. The auditor stated to “Please see code category G93.4 which has an excludes 1 note excluding “...Read More »