Note from the Associate Editorial Director: CDI Journal focuses on regulatory change, rising denial tides

by Linnea Archibald

November and December tend to be filled with a quiet sort of busyness, the kind of busyness that looks like lingering around a holiday dinner table with those you love, drinking your morning cup of coffee in holiday-themed pajamas, and curling up on the couch in front of a fire with a good book. While autumn has always been my favorite season of the year, there’s something magical about winter coziness.

For those in the CDI profession, the November/December edition of the CDI Journal finds you one month into the new fiscal year, hopefully beginning to settle into any new review focus areas that change has brought, allowing you the time to relax a bit before the calendar flips officially to 2022.

Just a month ago, October 1 brought a host of regulatory changes for healthcare organizations. Consequently, CDI professionals often find themselves spending more time reading mountains of regulatory publications that may leave them feeling bleary eyed at the beginning of the fiscal year. The changes to regulations can influence organizations’ financial bottom lines, their quality score performance, and the volume and/or type of denials they receive.

We hope you’re beginning to crawl out from under the pile of new rulemaking documents, but as we look toward the beginning of the new calendar year, we wanted to spend a bit of time discussing regulatory nuances, the process by which changes get made, and how CDI professionals can both effect positive regulatory change and keep their heads above the waters of ever-increasing denials.

Within the newest Journal’s pages, readers will learn about

• Submitting suggestions for the inpatient prospective payment system final rule
• Tackling outpatient denials
• Approaching denials like a defense attorney
• Sending questions to Coding Clinic
• The role physicians play in denials management
• Preventing denials for sepsis and acute respiratory distress syndrome
• Reviewing for Vizient indicators
• Maintaining ethical quality review practices

This edition also includes articles offering insight into the latest heart failure definitions, research related to CDI and nursing documentation, advice for jumping into your professional network with both feet from ACDIS Editorial Director Melissa Varnavas, and a behind-the-scenes look at the latest ACDIS position paper focused on risk adjustment from ACDIS Director Brian Murphy. Plus, our edition closes with our regular Meet a Member feature, which is always full of great tips and advice.

The ACDIS team hopes you enjoy this latest edition and find some helpful information to meet the regulatory and denial tides head on. The January/February 2022 edition of the CDI Journal will focus on CDI basics and leadership principles, so if you’d like to contribute, wish to share your CDI journey, or suggest an article idea, please feel free to email us.

Editor’s note: Archibald is the associate editorial director of publications and membership for ACDIS. Contact her at larchibald@acdis.org.