Q: Consider patients who are admitted with cellulitis and have type 2 diabetes mellitus with no neuropathy or elevated glucose levels. Should coders query the provider to clarify if the cellulitis is caused by the diabetes, or should such a query only be sent if a patient has other...Read More »
Insurance claim denials and DRG downgrades are frequent concerns and growing areas of focus for CDI programs. CDI functions have expanded to include denial mitigation in their record review process, seeking to capture patient complexity, clarify documentation inconsistencies, and clinically...Read More »
ACDIS developed the Certified Clinical Documentation Specialist-Outpatient (CCDS-O) to provide a trusted baseline of competency for CDI in the outpatient setting. Currently, the CCDS-O exam uses the CMS-HCC Risk Adjustment Model Version 24, but the exam will be updated to Version 28 on October 1...Read More »
In a previous version of CDI Strategies, we shared a few suggestions for how you might celebrate CDI Week with your chapter this September 16-20. This week, we want to hear from you...Read More »
I’ve written before about how I loved being a student all through my educational years, and I think many of you reading this article are in the same boat with me. That’s one of the things that attracts professionals to the CDI industry: There’s always...Read More »
According to a recent KFF analysis, healthcare organizations are submitting more prior authorization requests to Medicare Advantage (MA) plans than they...Read More »
