ACDIS Associate Editorial Director Linnea Archibald sends out “missed connections” emails with questions from Council members on a regular basis. Anyone with experience related to one of the questions was invited to respond and Archibald connected them with the question-asker. In order to share...Read More »
Inpatient coders are familiar with risk-adjusted methodologies—where a combination of diagnoses lead to higher-weighted code groupings--but many outpatient coders may not have encountered them.
That's likely to change as hierarchical condition category (HCCs)
CDI specialists typically review inpatient records to obtain specificity related to principal and secondary diagnosis. As a profession, such staff combine clinical knowledge with coding, billing, and documentation experience. Although not as prevalent as inpatient efforts, outpatient CDI is a...Read More »
Auditors have been reviewing medical necessity for inpatient services for years and Recovery Auditors (RA) have recouped millions of dollars in overpayments. Now outpatient providers are beginning to see more and more medical necessity audits, especially in the ED and for evaluation and...Read More »
Q: Do you recommend carving out time for outpatient [documentation] review, or dedicating someone to this role?
A: We actually carve out time for outpatient review. We started with two initiatives in our ED. One was injections/infusions and documentation...Read More »
