CDI Strategies - Volume 5, Issue 18

News: Baptist Healthcare settles after claims of improper billing for sepsis, respiratory failure

September 2, 2011
News

$8.9 million. That is the amount Kentucky-based Baptist Healthcare Systems, Inc., had to pay as of September 1 to settle claims of improper billing related to respiratory infections and inflammations, pulmonary edema (fluid accumulation in the lungs), respiratory failure, and septicemia (blood...Read More »
CDI Strategies - Volume 5, Issue 18

CMS releases updated RAC Statement of Work

September 15, 2011
Quality & Regulatory

CMS updated its Recovery Audit Contractor Statement of Work (SOW), according to an article in ...Read More »
CDI Strategies - Volume 5, Issue 18

News: TrailBlazer probe highlights documentation disparity

September 2, 2011
News, Quality & Regulatory

Out of 88 claims for MS-DRG 246 (percutaneous cardiovascular procedure with drug-eluting stent with MCC or 4+ vessels/stents with a length of stay less than or equal to two days) reviewed during a recent probe audit, TrailBlazer Health Enterprises, LCC, fully denied 65 of them,...Read More »
CDI Strategies - Volume 5, Issue 18

News: HospitalCompare lists readmission 'worsts'

September 15, 2011
News, Quality & Regulatory

Being described as "worse" in a CMS HospitalCompare data file is a dubious distinction. 

A recent HospitalCompare list identifies 292 hospitals with 30-day readmission rates that are the highest in the nation in at least one of three disease categories— acute myocardial infarction,...Read More »
CDI Strategies - Volume 5, Issue 18

News: Lackluster RAC returns could spur fourth quarter records rush

September 2, 2011
News

To make up a gap in expected overpayment collections Recovery Audit Contractors may escalate audit activities in the coming months, according to an article by Vickie...Read More »
CDI Strategies - Volume 5, Issue 18

Tip: Take photographs of your CDI team to celebrate CDI Week

September 15, 2011
ACDIS Guidance

If you’re looking for an easy, inexpensive way to celebrate the first annual Clinical Documentation Improvement Week Sept. 18-24, consider having some fun with photographs of your CDI team.

Provena and Resurrection Hospitals, which includes eight hospitals plus Provena Corporate,...Read More »
CDI Strategies - Volume 5, Issue 18

News: GAO report says CMS needs to improve quality of physician feedback

September 2, 2011
News, Quality & Regulatory

“CMS faces challenges incorporating resource use and quality measures for physician feedback reports that are meaningful, actionable, and reliable,” according to an August 12 report from the Government Accountability Office.
CDI Strategies - Volume 5, Issue 18

Q&A: When to query physicians regarding pathological findings

September 15, 2011
Ask ACDIS
When a condition meets reporting guidelines for the inpatient admission, is it appropriate to use documentation dated outside the inpatient admission for coding purposes? Are there specific laws or guidelines that prohibit coding from documentation dated outside the inpatient admission?...Read More »

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