CDI Strategies - Volume 6, Issue 15

News: AHRQ seeks volunteers

July 19, 2012
News

The Agency for Healthcare Research and Quality (AHRQ) is seeking nominations for its ICD-10-CM/PCS Conversion of Quality Indicators (QIs) workgroup. The text of the notice, including workgroup selection criteria and specific activities, may be found at...Read More »
CDI Strategies - Volume 6, Issue 15

News: Conditions of Participation eases 48 hour requirement for signing orders

July 19, 2012
News, Quality & Regulatory

The proposed rule changes for the Conditions of Participations (CoP) were recently finalized. They include some relief regarding rules for physicians signing, dating, and timing verbal orders within 48 hours of the order being given.

According to the new rule, HHS eliminated the...Read More »
CDI Strategies - Volume 6, Issue 15

Q&A: Documentation and coding for post-operative complications related to COPD

July 19, 2012
Ask ACDIS

We recently had a case where a patient with severe chronic obstructive pulmonary disease (COPD) was admitted for several lung lesions. The patient went to surgery for de-cortication of lung due to left lung entrapment with adhesions, deep wedge resection of mass of the upper lung and left lower...Read More »
CDI Blog - Volume 6, Issue 14

Nashville Conference Buzz: Sneak peek into ‘Yes SIRS, No SIRS’

April 29, 2013
Ask ACDIS, Clinical & Coding

Editor’s Note: This is the second post in a series of articles showcasing speakers at the ...Read More »
CDI Strategies - Volume 6, Issue 14

Director’s Note: Get ready for the second annual Clinical Documentation Improvement Week

July 5, 2012
ACDIS Guidance

After hosting the first Clinical Documentation Improvement Week last year, ACDIS and the CDI Recognition Committee are back preparing for No. 2.

This year CDI Week will take place September 16–22.
 
Last year’s theme was “Paving the Path (To an...Read More »
CDI Strategies - Volume 6, Issue 14

Tip: Start with emergency room documentation to help reduce claims denials

July 5, 2012
CDI Expansion

By Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDI, CCDS

Broaden the scope of your CDI efforts by looking for medical necessity indicators and increasing proactive efforts to reduce audit risks.
 
CDI specialists can increase their value to their...Read More »
CDI Strategies - Volume 6, Issue 14

Tip: Coding for inpatient postoperative complications requires explicit documentation

July 5, 2012
Quality & Regulatory, CDI Expansion

Determining when to code a post-surgical complication as opposed to simply considering it to be an expected outcome after surgery can be a complicated task.

A complication is “a condition that occurred after admission that, because of its presence with a specific principal diagnosis,...Read More »
CDI Strategies - Volume 6, Issue 14

Q&A: Determine medical necessity for inpatient admissions for COPD

July 5, 2012
Ask ACDIS

Our hospital serves a higher than usual population with COPD. Most of these cases are chronic and the patient is typically on home oxygen. Blood gases are almost never obtained on admission unless the patient is placed on a ventilator. Is acceptable to query the physician for chronic respiratory...Read More »

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