by Susan Schmitz, JD, RN, CCS, CCDS, CDIP
If you’re anything like me, I imagine you were quite relieved when the fiscal year (FY) 2020 inpatient prospective payment system (IPPS) final rule came out. The proposed rule with its thousands of CC and hundreds of MCC downgrades proved...Read More »
Prior to 1983, Medicare reimbursed based on actual charges that inpatient healthcare facilities billed (often referred to as “fee-for-service” payments). The more tests, procedures, and services ordered by physicians, the more an organization was paid. This created the potential for unnecessary...Read More »
This FAQ was created by the authors of the ACDIS/AHIMA “Guidelines for Achieving a Compliant Query Practice (2019 Update),” to provide additional clarity.Read More »
For many years now, healthcare reimbursement has been based not only on whether care was provided but on how well that care was provided and the patient’s outcome following that care.
While the premise for quality programs is largely the same across the board—measure the quality of care...Read More »
According to this year’s CDI Week Industry Survey, only 10.38% of respondents (most of whom work in inpatient settings) don’t review for quality measures, continuing a year-over-year decline. For most folks on the inpatient side of the CDI world, reviewing for quality isn’t an expansion area...Read More »
“We felt that if we had our own internal dedicated team, we could watch [CDI efforts] much more closely,” said Caryl Liptak, MSHAI, RHIA, system director of CDI and coding at Baptist Health System in Louisville, Kentucky, when asked about bringing their home health CDI program in-house instead...Read More »
The fiscal year 2020 Inpatient Prospective Payment System (IPPS) proposed rule threw gas on the population health fire when it proposed giving social determinants of health (SDOH) codes more weight as complications/comorbid conditions (CC). The final rule threw some water on the pyre, however,...Read More »
The ICD-10 Coordination and Maintenance (C&M) Committee met on September 10–11, 2019 to discuss code proposals for implementation on October 1, 2020, for fiscal year 2021. Several members of the ACDIS CDI Regulatory Committee listened to or...Read More »