Q: AHIMA’s 2008 practice brief, “Managing an Effective Query Process,” appears to allow the initiation of post-bill queries as a result of an audit or other internal monitor. Historically we believed that a query completed after the initial bill was not permitted to be submitted for...Read More »
Congestive heart failure (CHF) is one example of a condition for which coders and CDI specialists should understand clinical indicators before querying physicians, says Lynne Spryszak, RN, CCDS, CPC-A, a CDI educator at HCPro, Inc., in Marblehead, MA.
Despite some misconceptions to the contrary, a coder may report angina, unstable (411.1) if a physician documents any of the following diagnoses and a query is not required:
Many CDI specialists struggle with the problem of educating physicians about documentation requirements. Typical trouble areas include acute kidney failure versus acute renal failure or acute renal injury. While some CDI managers have a chance to educate new physician staff in one-on-one...Read More »
Recent CDI-related headlines include concerns about the burden of paperwork on patient care and the cost of healthcare. And article authors cite a few recent surveys to back up such assertions.
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 the...Read More »
Q:Since Acute Renal Failure (ARF) is no longer a MCC (as of October 1, 2010). I would like some input on how facilities have coped with the change. Do you just code ARF, or have you started querying physicians for more specific information such as documentation for...Read More »
