The Government Accountability Office (GAO) offered mixed reviews of CMS’ handling of the Recovery Audit Contractor (RAC) demonstration program, according to a report released March 31. While the...Read More »
Q: I have been dealing with a denial issue where, because a chest x-ray did not show pneumonia and a repeat x-ray was not performed, the pneumonia was denied. In dehydrated or immunocompromised patient the chest x-ray may not initially show the pneumonia. I am now looking for supporting...Read More »
In 2008, the Office of Inspector General (OIG) reviewed a sample of nearly 300 Medicare hospitalizations from two counties in a one-week period in order to analyze current methods of identifying adverse events in hospitals. According to a report released this month, vulnerabilities exist in...Read More »
For CDI specialists, the physician signature is one more critical piece of documentation to keep an eye on. Actually, it’s one of primary reasons to query the physician according to the AHIMA physician query practice brief, “Managing an Effective Query Process”. CMS Transmittal 326 (Change...Read More »
The question of whether to retain queries as a permanent part of the medical record increased in importance this spring as recovery audit contractors (RAC) included queries on the list of records they requested as part of complex audits.
“Once upon a time, there were no query police, But...Read More »
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 »
