Be aware of payer’s “home cooked” clinical criteria which are often not only outdated, but also ridiculous. Contrary to what the payer may claim, a patient does not regularly have to be at a near death state before having achieved grounds...Read More »
Generally speaking, developing consistent query policies and procedures for both coding and CDI staff helps keep everyone in compliance with coding regulations. Similarly, work with clinicians, CDI specialists, and coders as often as...Read More »
Vinita Magoon, DO, JD, MBA, MPH, CMQ, presented a poster at the 2018 ACDIS Conference entitled “Using denial data to improve outpatient clinical documentation.” Read More »
No, we don’t mean the common table spice. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) summarizes facility-specific data statistics for Medicare services that may be at risk for improper payments.Read More »
Tammy Combs, RN, MSN, CDIP, CCS, CCDS, will present “How to Mitigate and Manage Denials,” on Day 2 of the ACDIS conference. Combs is the director of HIM practice excellence, CDI/nurse planner at AHIMA in Chicago, Illinois....Read More »
Rush University Medical Center in Chicago did not comply with Medicare billing requirements for 57 inpatient and outpatient claims reviewed by the OIG, according to the OIG’s November report. According to the report, this...Read More »
