The Association of Clinical Documentation Improvement Specialists (ACDIS) is pleased to comment on the Centers for Medicare & Medicaid Services’ (CMS) proposed changes to the Medicare hospital inpatient prospective payment system (IPPS) and proposed fiscal year (FY) 2011 rates, as published...Read More »
Every institution reading this column has likely received its first recovery audit contractor (RAC) denials regarding the documentation and coding of excisional debridement procedures (86.22). Our hospital is no exception. While we knew that this...Read More »
Connolly Healthcare, CMS’ recovery audit contractor (RAC) for Region C, announced its first targets for complex review with a list of 24-DRGs in December 2009. A few weeks later it added 15 more DRGs to its list.
Connolly’s list was the first published, so it provided a good preview
Those working in CDI and quality improvement (QI)/ core measure review may have to rethink the old adage of playing separate roles. As Shakespeare writes in As You Like It, “All the world’s a stage … and all are merely players. … One man in his time plays many parts.”
Q: What quality-/core measure–focused training materials do you recommend for CDI specialists?
A: Some training materials may be at your disposal already and you may not be aware of them. Check with your Quality Improvement Organization.Read More »
In 1994, the Indiana Heart Institute decided to implement a dedicated cardiovascular quality data abstraction team. In 1996, the hospital expanded the team’s duties to include CDI responsibilities. This revised team obtained the information necessary for coding, as well as all the information...Read More »
In 2009, HCPro's Revenue Cycle Institute conducted an in-depth study on recovery audit contractor (RAC) preparedness among healthcare providers. It garnered 717 responses from all four RAC jurisdictions. Respondents hailed from healthcare providers of various sizes: 25% came from hospitals with...Read More »
Septicemia has been problematic for some time. Coders often misunderstand the ICD-9-CM Official Guidelines for Coding and Reporting as it pertains to the sequencing of the assigned codes, says Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CCDS, director of HIM