The Hospital Readmissions Reduction Program (HRRP) allows CMS to penalize hospitals with excess readmissions, as written in Section 3025 of the Affordable Care Act, which added section 1886(q) to the Social Security Act. Specifically, the...Read More »
Mortality reviews are becoming more prevalent in the CDI world. But what do they really mean for CDI specialists? Some organizations have mortality review committees, but such reviews don’t always fall under CDI; they could be managed by the quality...Read More »
by Joel Moorhead, MD, PhD, CPC
This article is about bringing the patient to the center of clinical validation. A patient with an “atypical” presentation, by definition, may have the disease but might not meet “typical” criteria for diagnosis.Read More »
Septic patients can quickly deteriorate into severe sepsis cases if left unattended. “Once they have organ failure, it’s really hard to get those patients back,” Connie Chappelle, RN, MC, CLNC, risk management coordinator for Kansas University Medical Center (KUMC) in Kansas...Read More »
by Amy Czahor, RHIT, CDIP, CCS
Recently I was reviewing a data sample investigating the root cause of DRG discrepancies between CDI and coding. More than half of the cases with a discrepancy were attributed to a difference in principal diagnosis selection.Read More »
CDI specialists can pretty much come from any background in the medical field—from physicians, to nurses, to coders, and everything in between. While CDI specialists generally have the same day-to-day workflow (reviewing charts and sending queries), a specialist’s background prior to coming to...Read More »
by Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS
To limit exposure to claim denials and external reviews, the best safeguard for a facility is a robust, effective internal coding compliance policy, plan, and program.
Begin by reviewing any existing coding policies and...Read More »
