The gyms are crowded this time of year. The first week of January, not so much. Second week of January, traffic picks up. Third week of January, the gym gets packed as people begin to realize that the month is almost passed them by and their get healthy, get thin, get more involved resolutions...Read More »
Rani Stoddard, MBA, RN, CPHQ, RHIA, CCDS, CCS, CDIP, is the CDI and HIM supervisor at Henry Mayo Newhall Hospital in Valencia, California, and the secretary, board member, and newsletter editor for the California ACDIS local chapter. She has been in the CDI field since 2014.Read More »
We’re having a lot of discussions lately on whether we should query for pressure injuries when they’re only documented by nursing. Our wound care nurses determined that staff nurses identify pressure injuries correctly only 60% of the time. If we’re querying based on nursing documentation, our...Read More »
Q: Most of the hospitals in our system make the query a progress note in the patient’s medical record. The provider puts an “X” by the appropriate answer choice and signs the note. At that point, the query is part of the permanent medical record and can be used for coding....Read More »
How should we handle denied claims when the payer refuses payment under the billed status? Do we need to document that the status was changed only because the payer did not agree to any other options?Read More »
The holidays are fast approaching, which makes it the perfect time to pause express my deep gratitude to the ACDIS membership. You all played a critical role in every one our major accomplishments and milestones this past year.
If the primary diagnosis is cerebral vascular accident (CVA), can we leverage the secondary diagnosis of hemiplegia to add a CC? Or is this considered in the same Major Diagnostic Category (MDC), Diseases and disorders of the nervous system?Read More »
