CDI Strategies - Volume 5, Issue 15

News: RACs target ventilator support

July 21, 2011
News, Quality & Regulatory

RACs can easily data-mine for noncompliance related to coding for ventilator support, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS, independent revenue cycle consultant in Madison, WI. For example, patients whose length of stay is fewer than two days can’t...Read More »
CDI Strategies - Volume 5, Issue 15

Tip: Root operations terminology will make a difference in ICD-10 coding

July 21, 2011
Clinical & Coding
ICD-10-PCS codes include one digit for the root operation that the provider performs. The root operation is always the third character in the seven-character code. The definitions of these root operations are consistent across other sections of ICD-10-PCS, although they may be represented by...Read More »
CDI Strategies - Volume 5, Issue 15

Q&A: Developing a query for malnutrition

July 21, 2011
Ask ACDIS, Clinical & Coding, Physician Queries

Q: Recently I have discussed the BMI and malnutrition status on patients with our Registered Dieticians (RD).  The question arose as to where our criteria came from.  I understand that the...Read More »
CDI Strategies - Volume 5, Issue 15

News: Congratulations to new CCDS credentialees

July 21, 2011
News

The latest group of recipients of the CCDS credential met the requirements for the CCDS certification program and passed the exam in the period between April 2, 2011, and June 30, 2011. View the complete list here. ACDIS will continue to...Read More »
CDI Blog - Volume 5, Issue 14

Guest Post: The clash of clinical vs. coverage/payment concerns

April 18, 2012
ACDIS Guidance, Education, Denials & Appeals

by Trey La Charité, MD

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 »
CDI Strategies - Volume 5, Issue 14

News: Special MLN Matters article discusses RAC DRG vulnerabilities

July 7, 2011
News, Quality & Regulatory

Inpatient hospital claims submitted to Medicare contain “a significant amount” of incorrect principal diagnoses, according to a Special MedLearn Matters article (SE1121) released June 23. Recovery Audit Contractors...Read More »
CDI Strategies - Volume 5, Issue 14

News: MAC contractor identifies E/M billing errors

July 7, 2011
News

Evaluation and Management (E/M) services accounted for $28 billion in Part B payments nationally from April 2009 to May 2010, ...Read More »
CDI Strategies - Volume 5, Issue 14

Tip: Query to clarify use of the term ’history’

July 7, 2011
Physician Queries, Clinical & Coding

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 »

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