By Jocelyn E. Murray, RN, CCDS
What are the similarities and differences between CDI audits and coding compliance audits? Are both necessary? It’s our collective responsibility to provide the insight that defines the two specialties and the critical efforts both bring to the table...Read More »
No, we don’t mean the common table spice. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is distributed by TMF Health Quality Institute under contract with CMS and summarizes facility-specific data statistics for Medicare services that may be at risk for improper payments...Read More »
Documentation improvement efforts related to denials management and audit prevention feel a lot like a trip through Alice’s looking glass, too. The list of auditing agencies alone can make CDI specialists feel like they’ve fallen into an alternative universe:...Read More »
By Tamara A. Hicks, RN, BSN, MHA, CCS, CCDS, ACM-RN
The old adage, “the best defense is a good offense,” comes to mind when I think about the role of CDI in audit defense. Our job is to improve documentation. A number of positive outcomes result from clinical documentation work...Read More »
Trey La Charité, MD, FACP, SFHM, CCS, CCDS
Appeal writing, like most things in a hospital, is a learned skill. Keeping things simple, both in terms of the arguments constructed and the language used in the letters themselves, will prevent you from creating horrific monstrosities...Read More »
No matter how thorough the documentation, no matter how precise the coding, denials still haunt the halls of most facilities. While many facilities have a denials department handling all appeals, others incorporate physician advisors and CDI professionals into the equation. Differing...Read More »
By Janie L. Brown, RN
Denied. It’s a word that no one wants to hear in any context. In healthcare, it’s a heavily weighted word. It means that, in spite of our best efforts to provide excellent care to our patients and to document that care appropriately, we are not receiving...Read More »
