The CDI specialist’s role is changing. It’s no longer enough to query for diagnoses and report corresponding codes. The diagnosis must be backed up by clinical indicators and thorough documentation—or it risks being overturned by an auditing agency. Read More »
Query revision for ICD-10-CM/ PCS compliance is underway for at least 51% of those responding to a recent ACDIS poll. Of the 657 responses, 46% indicated that their facility has not embarked on a query update project, with 3% waiting until after the implementation date and 14% indicating they...Read More »
The battle over timely reviews for Medicare claims denials continues despite a federal court’s decision to dismiss an American Hospital Association (AHA) lawsuit in December. The suit, brought by the AHA and several hospitals, sought to have the courts compel the Department of Health and Human...Read More »
“Better, Smarter, Healthier” was the headline which topped a January announcement shifting value-based purchasing (VBP) goals and shortening implementation deadlines.
By 2016, 85% of all traditional Medicare payments will be tied to quality or value. By 2018, 90% of all payments will have...Read More »
The Department of Justice (DOJ) recovered $5.69 billion in False Claims Act settlements in fiscal year (FY) 2014; $2.3 billion of which against federal healthcare programs,...Read More »
The Government Accountability Office (GAO) found that while CMS’ transparency tools such as its Hospital and Physician Compare websites “provide some clinical quality information relevant to consumers, they often lack condition-specific information for the type of non-urgent procedures that...Read More »
As you put the final touches on your itinerary, we have a couple more speaker previews that we’d like to share with you. This week, we spoke with Allison Clerval, RN, BSN, CCDS and Kathleen M. Shindle, RN, BSN, CCDS, who will present “A Matter of Life and Death: CDI Impact on Mortality Risk...Read More »
