Quality & Regulatory

Q: Are there any coding guidelines/definitions regarding code 518.5 (Pulmonary insufficiency following trauma and surgery) vs. the use of 518.81 (...Read More »

by Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, CCDS, C-CDI

The overarching goal of a documentation improvement program is...Read More »

The RACs have ramped up medical necessity reviews. Determining the medical necessity of an inpatient admission can be a complex process so we have...Read More »

A recent special edition MedLearn Matters article SE1028 outlines four risk areas targeted by the recovery audit...Read More »

Q: I have been dealing with a denial issue where, because a chest x-ray did not show pneumonia and a repeat x-ray was not performed, the...Read More »

by Trey La Charité, MD

CMS detailed seven shortcomings, including old and inadequate policies and procedures, in its 2009 audits of healthcare organizations to determine...Read More »

by Trey La Charité, MD
Every institution reading this column has likely received its first recovery audit contractor (RAC) denials...Read More »

The Medicare Learning Network released three fact sheets of interest to CDI staff:

• The “Hospital Acquired Conditions (HAC) in Acute
...Read More »

The Hospital Compare website, updated on Dec. 11, contains three new inpatient measures. These include Surgical Care Improvement Project (SCIP)...Read More »