CMS has been holding a number of open forum calls regarding its Recovery Audit Contractor (RAC) programs. Dubbed “Nationwide RAC 101 Calls” these sessions covered the basics of RAC reviews, each focusing on a different provider area.
The first call on April 28, intended for all acute...Read More »
Effective January 1, 2011, CMS will start to accept up to 25 codes for secondary diagnoses. The change, listed in a March 2010 MedLearn Matters article and also listed in the...Read More »
CDI specialists are getting too tied up with the minutiae of ICD-9-CM coding and DRG optimization instead of focusing on the overall clinical picture of the patient and the integrity of the medical record, says Glenn Krauss, RHIA, CCS, CCS-P, CPUR, FCS, PCS, CCDS, C-CDI, an independent...Read More »
The American Health Information Management Association (AHIMA) published its Clinical Documentation Improvement Toolkit earlier this month. The 41-page document offers sample job descriptions for CDI specialists and physician advisers to CDI, provides definitions for documentation...Read More »
Despite the inclination of many hospital administrators to mechanize documentation and abstraction of quality measures, Kristen Geissler, MS, PT, MBA, CPHQ, associate director in the Healthcare Clinical Economics Practice at Navigant Consulting, Inc., in Baltimore, hasn’t heard of anyone able to...Read More »
Many CDI specialists struggle with the problem of educating physicians about documentation requirements. Typical trouble areas include acute kidney failure versus acute renal failure or acute renal injury. While some CDI managers have a chance to educate new physician staff in one-on-one...Read More »
Q: Our CDI specialists tend to ask questions that provide the physician with multiple options to choose from. It is not uncommon to have a query with multiple answers checked by the physician.