When evaluating overall compliance within a CDI department, Lynne Spryszak, RN, CCDS, CPC-A, CDI education director for HCPro, Inc., in Danvers, MA, says that CDI department managers should:
Try not to confine your reviews to a particular payer. Although everyone
The Department of Justice (DOJ) recovered $2.5 billion in healthcare fraud recoveries for fiscal year (FY) 2010—the largest in history—and $3 billion in total civil fraud claims, according to a DOJ press release. Of that...Read More »
CMS has modified the additional documentation request (ADR) limits (i.e., medical record request limits) for the RAC program in 2011, according to document posted November 10 on the...Read More »
On October 14, we reported that CMS issued a controversial MLN Matters special edition (SE) article which stated that all inpatient admissions needed to have any/all ‘other’ or ‘secondary’ diagnoses documented by the attending physician.
Realizing that the go-live date won’t change, some facilities already have organization-wide ICD-10 implementation strategies in place. If your CDI program hasn’t yet been involved in ICD-10 discussions or if your facility hasn’t starting the planning process yet, consider incorporating elements...Read More »
There may be hope for hospitals carefully watching the proposed IPPS rule, praying for some amelioration of the suggested 2.9% documentation and coding adjustment (DCA) it included. On July 12, 242 members of Congress...Read More »
A special edition MLN Matters article released last week points to two common reasons for RAC claims denials—lack of timely submission of requested documentation and lack of documentation supporting medical...Read More »