When two conditions are both present on admission, both meet definition to be the principal diagnosis, and are “equally treated,” my understanding is that the condition does not have to be "equally treated" in the sense of duration/frequency. Can you provide the actual verbiage of the coding...Read More »
Is your CDI team going back to onsite work or staying remote even after the COVID-19 crisis has subsided? How has the COVID-19 pandemic affected your CDI department for the long run? Read More »
My organization has received three denials for the diagnosis of severe calorie malnutrition based on the Global Leadership Initiative on Malnutrition (GLIM) criteria. All three denials came from the same small insurance company. We don’t use GLIM criteria at our organization currently. Should we...Read More »
If the medical record includes documentation of the dietitian recommending the administration of Glucerna, Ensure, etc., can we capture that? Even if the recommendation was never ordered or given? Or does it have to be an actual treatment that was both ordered and done?Read More »
What actions do CDI teams take when staff receive “unable to clinically determine” responses to queries? Some physicians may use this as an easy query “out” versus addressing the clinical question and we are seeing some repeat offenders. We started tracking and presenting these to our physician...Read More »
I've been told that if there are clinical indicators to support that chronic kidney disease (CKD) is the etiology of a patient’s hypertension, a code from category I15 would be assigned. Code I12 is for hypertensive CKD, isn’t it? So why do we have to use I15 codes instead? What’s the main...Read More »
Q: Have any other institutions had frequent clinical validation denials regarding acute pulmonary insufficiency following surgery? If so, what clinical indicators and resources do you use to appeal the denials?Read More »
What areas in the facility should be reviewed as part of outpatient CDI reviews (e.g., emergency department, same-day surgery, hospital-owned physician practices, etc.)? Does outpatient CDI include patients in the hospital currently in observation status? Do inpatient CDI specialists review...Read More »