Tip: AHA Audit Education Series offers CDI program targets, support
May 24, 2012
CDI Strategies - Volume 6, Issue 11
The May 14 American Hospital Association (AHA) edition of its Audit Education Series: Reducing vulnerabilities to payment denials “advises organizations to take action to reduce their vulnerabilities to payment denials.” The more than 30-page document highlights top audit risk areas and offers suggestions for how hospitals may ameliorate such risks, including increased focus on documentation improvement and coding accuracy.
“An emphasis on both documentation and coding is critical to minimize your risk for denials,” the report states. “Without consistent and complete documentation in the medical record, accurate coding cannot be achieved. While your hospital may have many of the processes below in place, we encourage you to revisit your policies and practices to help reduce your hospital’s denials.”
The report further cites the AHIMA "Managing an Effective Query Process" practice brief and outlines several query opportunities. It also provides a sample “Inpatient Documentation Prompter” prepared by Texas QIO TMF Health Quality Institute.