Many CDI specialists come from a purely coding background, while others who have a purely clinical background seek additional education in the coding realm and have attained certification in the field of coding. Regardless of the...Read More »
Physician advisors do everything from providing pre-/postbill clinical documentation support to assisting with Recovery Auditor (RA) appeals and drafting appeal letters to reviewing charts for medical necessity of inpatient admissions.Read More »
Q: I’ve heard that the provider should identify the level of substance consumption. For provider education, would the CDI department need to cite any clinical indicators that would help providers differentiate use, abuse, or dependence? Or should we...Read More »
By Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS
A commonly recommended audit sample size is 30 cases for routine quality auditing with no known serious compliance issues. Conducting an audit of this magnitude for every coder every month can be a daunting challenge....Read More »
With the advent of the Affordable Care Act in 2010, CMS announced that it would no longer reimburse hospital costs associated with preventable conditions such as mistakes in care or hospital-acquired infections. CMS began incentivizing eligible hospitals...Read More »
Q: Recently, our inpatient psychiatric facility has been asking if it would be beneficial to have CDI review their accounts. I researched this a few years back and learned from other programs that there was little benefit as most psych DRGs are single...Read More »
By Cheryl Ericson, RN, MS, CCDS, CDIP, and Cathy Farraher, RN, MBA, CCM, CCDS
Whenever CDI staff is uncomfortable sending a clinical validation query, the physician advisor should be consulted both prior to sending it, as well as prior to following up on the response if necessary...Read More »
