In the aggressive post-discharge auditing environment where I now find myself practicing medicine, I and my colleagues are subject to heavy scrutiny by CMS and private insurers. Observation versus inpatient status review is the new focus of these non-...Read More »
Many cases exist in which CDI specialists need to query physicians to clarify the use of the term “history.” Consider the following situation in which a physician admits a patient with pyelonephritis. The past history states right lower lobe lung carcinoma proximal lesion. ...Read More »
I previously started a conversation on CDI Talk entitled “Failed Programs,” hoping there might be someone willing to divulge an account of how and why their program “failed,” perhaps even how they were able to “save” or “reinvent” it. While the post generated quite a bit of conversation (there...Read More »
Q:I have been trying to determine whether a skin graft includes debridement. Based on what I have read in the Official Guidelines for Coding and Reporting and ...Read More »
by Glenn Krauss, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS
Because most CMS local and national coverage determinations governing medical necessity and limitations of coverage center around outpatient procedures (e.g., lesion removals, cataract surgeries, and blepharoplasty repairs),...Read More »
