CDI Strategies - Volume 4, Issue 12

Tip: Use PEPPER reports to search for CDI targets

June 10, 2010
CDI Management, Quality & Regulatory

The Program for Evaluating Payment Patterns Electronic Report (PEPPER) includes a wealth of information regarding MS-DRG outliers that might otherwise go completely unnoticed. That’s what happened at Baptist Memorial Health Care Corp. until the 15-hospital health system began analyzing its...Read More »
CDI Strategies - Volume 4, Issue 9

Tip: Thinking of adding quality core measure review to the CDI role? Be aware of the challenges

April 29, 2010
CDI Expansion, Quality & Regulatory

Despite the inclination of many hospital administrators to mechanize documentation and abstraction of quality measures, Kristen Geissler, MS, PT, MBA, CPHQ, associate director in the Healthcare Clinical Economics Practice at Navigant Consulting, Inc., in Baltimore, hasn’t heard of anyone able to...Read More »
CDI Strategies - Volume 4, Issue 8

News: GAO report says more effort needed to reduce RAC target areas

April 15, 2010
News, Quality & Regulatory

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 »
CDI Strategies - Volume 4, Issue 8

Tip: Watch for postop or post-traumatic infections with OR procedures

April 15, 2010
Quality & Regulatory

CDI specialists would do well to keep an eye on documentation leading to three MS-DRGs that multiple RACs have listed on their approved audit issues:

  • 856 (postop or post-traumatic infection with operating room [OR] procedure with MCC)
  • 857 (postop
    • ...Read More »
CDI Blog - Volume 4, Issue 6

Q&A: Physician impression trumps x-ray results

February 9, 2011
Ask ACDIS, Quality & Regulatory

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 »
CDI Strategies - Volume 4, Issue 6

News: OIG identifies nurse/physician medical record review as most effective way to identify adverse events

March 18, 2010
News, Quality & Regulatory

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 »
CDI Strategies - Volume 4, Issue 6

News: CMS Transmittal focuses on physician signatures

March 18, 2010
News, Quality & Regulatory

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 »
CDI Journal - Volume 4, Issue 3

RACs request queries as complex reviews roll out

July 1, 2010
Quality & Regulatory

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 »

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