Providence St. Peter Hospital in Olympia, Washington, has had a successful inpatient CDI program for seven years. In spring 2014, the facility, which encompasses 32 clinics and two acute care hospitals, began discussing CDI in the ambulatory setting, says...Read More »
For CDI specialists, the daunting landscape of changing healthcare initiatives may seem like a broad expanse of impenetrable woods. It's an ecosystem which includes quality-based initiatives related to readmission reductions, 30-day mortality, Patient Safety Indicators, complications, present on...Read More »
Q: I am looking for additional clarification regarding the recent AHA Coding Clinic for ICD-10-CM/PCS concerning diabetes and the use of the word “with.” While the examples often used in Coding Clinic are specific, the actual...Read More »
Call me unorthodox, but let’s start at the back of the latest edition of the American Hospital Association (AHA)’s Coding Clinic for ICD-10-CM/PCS for this review. Here, on pp. 36–37, we have the clarifications, including some potentially confusing—and possibly conflicting—information...Read More »
Healthcare reimbursement is changing; both CMS and private payers are working toward payment methodologies that reflect quality of care versus quantity of care. In most cases, quality is measured based on patient outcomes. The concept of risk adjustment is now being applied to healthcare...Read More »
I have previously addressed the issue of auditor denials. However, given the industry changes I have witnessed in the last 12–18 months, it is time to revisit this problem. And, per communications with colleagues in the CDI world, I suspect the same...Read More »
When Dee Banet, RN, MSN, CCDS, CDIP, and her CDI team sent out a claim for a surgical patient with body mass index (BMI) greater than 40 with morbid obesity as a secondary diagnosis, they did not expect the claim to be denied; after all they...Read More »
Melinda Scharf, RN, BSN, CCDS, CCS, regional clinical documentation integrity educator at St. Joseph Hospital in Irvine, California, has worked in CDI since 2008 after serving as a pediatric nurse for 10 years and an ER nurse for 11.Read More »