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 »
Q: As part of an integrated access management program, what medical documents are needed to perform a medical necessity review so that the access care coordinator (ACC) can offer a level of care recommendation to the physician?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 »
The CDI Journal offers CE credits towards the ACDIS CCDS certification. To obtain your CCDS continuing education credits, you must successfully complete the online continuing education quiz. Please note: The expiration date for this activity is August 30, 2017. You must complete your online quiz...Read More »
