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 »
Q: How do you measure productivity for a denials specialist? Do you measure the number of appeals per day, per week, or per month? Are there any other tasks that affect this metric?Read More »
Q: Our system is seeing increasing cases being denied inpatient care with the suggestion that the cases should have been billed as observation. Right now, our coding department handles the coding-based denials, CDI handles clinical validation denials, and care management...Read More »
Does the ACDIS/AHIMA “Guidelines for Achieving a Compliant Query Practice” brief support queries that only list one diagnosis, “other,” and “unknown”? Read More »
Can you offer any insight as to how you are handling CMS’ new requirement for documentation of COVID-positive patients stating that the physician needs to document not only that the...Read More »
As part of the eleventh annual Clinical Documentation Integrity Week, ACDIS conducted a series of interviews with CDI professionals on a variety of emerging industry topics. Lora Diner, RN, CCDS, CDI manager at Centura Health in Centennial, Colorado, answered these questions. She is a member of...Read More »
