Q: Our CDI program is three years old and our administration still questions our productivity goals. Initially we set benchmarks at 90-95% coverage rate of Medicare/Managed Medicare; 20-25% query rate; 90% response rate and 80% agree rate. Since census varies, we also established goals of...Read More »
A November report from the Government Accountability Office (GAO) calls on CMS to provide better oversight of its key audit contractors specifically related to Medicaid. The report called the National Medicaid Audit Program (NMAP) “inefficient...Read More »
Depending on how they are sequenced, CC and MCC conditions can have a direct effect on MS-DRG assignment, says ACDIS Advisory Board member Cheryl Ericson, MS, RN, CCDS, CDIP, clinical documentation improvement (CDI) education director at HCPro, Inc. in Danvers, Mass., and an AHIMA-...Read More »
Q: A few times I have seen physicians document Schatzki’s Ring. I understand that if the physician documents “acquired Schatzki’s Ring” that maps to code 530.3 no CC/MCC. However, how would...Read More »
The fight over medical necessity continued last week as the American Hospital Association and its four co-plaintiffs asks courts to “expedite” a lawsuit against U.S. Department of Health and Human Services (HHS) for unfair Medicare practices pertaining to the Recovery Auditor program.
ICD-10-CM/PCS incorporates laterality, acuity, anatomical specificity, and a slew of additional combination and complication codes. Who will submit queries when this information is missing in a medical record? Will coders or CDI specialists take on this role? Perhaps it might be a combination of...Read More »
Q: Can you clarify the requirements surrounding the use of E codes? We have been working on documentation concerns related to patient safety indicator (PSI) 15 and wonder if E codes are really required to be reported or not. Can a facility simply decide to use on not to use them...Read More »
The nomination period for the ACDIS advisory board recently closed, and a nomination committee has begun reviewing the applications for four openings on the advisory board. Per ACDIS bylaws, the committee will narrow down the pool of applicants and put the finalists before the membership for a...Read More »
