News: Medical Center received nearly $1.7 million in overpayments, OIG says

February 8, 2018
CDI Strategies - Volume 12, Issue 6
Denials & Appeals, News, Outpatient CDI, Quality & Regulatory

Medicare incorrectly paid approximately $1.7 million to Carolinas Medical Center in Charlotte, North Carolina, as a result of incorrect billing on...Read More »

Tip: Use the OIG Work Plan to focus your CDI efforts

January 11, 2018
CDI Strategies - Volume 12, Issue 2
ACDIS Guidance, Education, Denials & Appeals

Those who’ve worked in CDI or healthcare compliance for any length of time typically prepare themselves for the annual October release of the OIG'...Read More »

Q&A: Coding diagnoses left out of the discharge summary

January 11, 2018
CDI Strategies - Volume 12, Issue 2
Ask ACDIS, Clinical & Coding, Denials & Appeals

Q: According to Official Guidelines for Coding and Reporting, uncertain diagnoses...Read More »

Q&A: Handling respiratory failure denials

January 4, 2018
CDI Strategies - Volume 12, Issue 1
Ask ACDIS, Denials & Appeals, Quality & Regulatory

Q: We’ve been getting denials on acute respiratory failure from Medicare Advantage plans. How...Read More »

Note from the ACDIS Director: The real face of fraud—it’s not CDI

December 14, 2017
CDI Strategies - Volume 11, Issue 57
ACDIS Guidance, Denials & Appeals, Quality & Regulatory

By Brian Murphy

In the stream of e-newsletters that flood my inbox each day I occasionally see reports that give me momentary...Read More »

Journal excerpt: Pass the PEPPER

December 14, 2017
CDI Strategies - Volume 11, Issue 57
ACDIS Guidance, Quality & Regulatory, Denials & Appeals

No, we don’t mean the common table spice. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) summarizes facility-specific data...Read More »

News: OIG requests $10.2 million in overpayment refunds from medical center

November 30, 2017
CDI Strategies - Volume 11, Issue 55
Denials & Appeals, News, Outpatient CDI, Quality & Regulatory

Rush University Medical Center in Chicago did not comply with Medicare billing requirements for 57 inpatient and outpatient claims reviewed by the...Read More »

Q&A: Tracking denials

November 9, 2017
CDI Blog - Volume 10, Issue 150
Ask ACDIS, Denials & Appeals, Quality & Regulatory

Q: When looking at denials timelines, what information should be noted?

A: There are many critical time...Read More »

Guest Column: CDI clinical validation and coding audits

November 1, 2017
CDI Journal - Volume 11, Issue 6
ACDIS Guidance, Clinical & Coding, Denials & Appeals

By Jocelyn E. Murray, RN, CCDS
What are the similarities and differences between CDI audits and coding compliance audits? Are both...Read More »

Pass the PEPPER: Benchmark CDI efforts and defend against denials

November 1, 2017
CDI Journal - Volume 11, Issue 6
ACDIS Guidance, Quality & Regulatory, Denials & Appeals

No, we don’t mean the common table spice. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is distributed by TMF Health...Read More »

Pages