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Member insight: Do health system defined diagnoses make a difference?
by Pamela Stence, RN, BSN, MSN, CCDS
I first heard about diagnosis definitions a few years ago on an ACDIS Quarterly Membership Conference Call, when Deanne Wilk, BSN, RN, CCDS, CCS, the CDI manager at Penn State Health in Hershey, Pennsylvania, mentioned that her organization had developed diagnosis definitions to assist in defending against downgrades and denials.
This conference call was about the time that UnitedHealthcare issued a statement that they were defining sepsis using the Sepsis-3 definition. At Sharp Healthcare, we were wrestling with the issue of sepsis, and I felt that developing a definition would help our organization to agree on how we would define the levels of sepsis based on clinical indicators.
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