It was hardly explicit that organizations could rebill on an outpatient basis (or fully bill) for services denied as non-medically necessary in an inpatient setting. However, on March 13, CMS issued a...Read More »
"Don’t let the relative quiet fool you,” says James S. Kennedy, MD, CCS, CDIP, president of CDI MD-Physician Champions in Smyrna, Tenn., “there are big changes in this year’s IPPS final rule, changes that represent a paradigm shift in the way CDI programs work.”Read More »
by Trey La Charité, MD
I realized, painfully, early in my career as a physician advisor for CDI that I needed to learn a lot more about coding and the process of translating physicians’ written words into ICD codes. I also needed a more secure footing to successfully appeal the ever...Read More »
by James P. Fee, MD, CCDS, and Garry L. Huff, MD, CCS, CCDS
Certainly, the alphabetical and tabular index of the ICD-9-CM codebook assume the “postoperative” relationship as causal, but a CDI specialist should investigate this further within the specific clinical context.Read More »
It’s been more than 12 years since AHIMA published its first recommendations governing coder-physician interactions. Since “Developing a Physician Query Process,” published in 2001, much in the healthcare industry has changed—and much change is still to come.
A November report from the Government Accountability Office (GAO) calls on CMS to provide better oversight of its key audit contractors specifically related to Medicaid. The report called the National Medicaid Audit Program (NMAP) “inefficient...Read More »
Connolly Healthcare, the Recovery Auditor (RA) for Region C, continues to focus on complex inpatient reviews of a long list of MS-DRGs. Regardless of whether this is your hospital’s RA, you need to ensure that your records reflect the...Read More »
