Before the first word of an appeal is ever written, review the denial chart thoroughly with the hospital’s appeal response ream. An appeal response team does not need to be big and certainly should not follow the usual constraints imposed...Read More »
Q:How does the Supplemental Medical Review Contractor (SMRC) determine which reviews to perform? Does SMRC work for CMS or our Medicare Administrative Contractor (MAC)? Read More »
Q: What are some times when it might be acceptable for a provider to copy and paste medical information into an electronic health record (EHR) and when is it absolutely not acceptable...Read More »
Q: I’ve heard that “exacerbated” can't be used to code acute-on-chronic congestive heart failure (CHF). Coding Clinic, however, states that it can be used. Can you clarify?
Q: We recently reviewed a troubling case related to sepsis core extractions which revealed that the patient did not have sepsis and the physicians did not document sepsis as there was no bacterial infection. The CDI specialist, however...Read More »
Q: After a video-assisted thorascopic surgery (VAT) procedure, a patient is usually receiving high flow oxygen. What circumstance might prompt a CDI specialist to query for acute respiratory failure in this situation? Read More »
Q:I’ve heard some conflicting advice regarding code group B95-B97, bacterial and viral infectious agents. I’ve heard that those codes don’t provide a CC or MCC as a secondary diagnosis in most cases. I’ve also heard that...Read More »
Q:How would you determine if the treatment is for the initial myocardial infarction (MI) as a secondary diagnosis versus the treatment for the subsequent MI?
