Our facility has adopted a systemwide definition of sepsis (based on Sepsis-3) and we’re having success with educating most providers. Some of our infectious disease providers, however, like to use the term septicemia which codes to A41.9, Sepsis, unspecified organism. This is somewhat of a...Read More »
What are some ways to assist with mortality reviews in order to identify missed opportunities and increase the severity of illness (SOI)/risk of mortality (ROM) scores for the case?Read More »
If a patient safety indicator (PSI) would be excluded because a procedure was emergent, do you still capture the code that would have triggered a PSI?Read More »
Q: Our dietitians send cases needing a query for malnutrition to our CDI staff. Previously, they were notifying providers of the need for the documentation of the diagnosis directly, but from a compliance perspective, they were more comfortable with us owning the formal query...Read More »
Under what circumstances and when is it appropriate to code flash (acute) pulmonary edema and acute-on-chronic heart failure (diastolic or systolic or other)? Would we need to query for both as flash (acute) pulmonary edema unrelated to acute/chronic heart failure?Read More »
I am seeing many patients who manifest diabetic ketoacidosis (DKA) and COVID-19 symptoms with provider documentation indicating that the COVID-19 infection likely drove the DKA. I have been sequencing COVID-19 as the principal diagnosis, but our coding team wants to use the DKA.
