By Sam Antonios, MD, MMM, FACP, SFHM, CPE, CCDS
Consider the story of a patient—say, a pneumonia patient—whose treatment cost a lot of money. The hospital’s reimbursement for that care, however, was less than the cost of providing it. Now say someone looked at that case and how...Read More »
Much like concurrent CDI reviews, the concurrent coding process necessitates that the coding professional follow the chart throughout the patient’s admission and code it at intervals. The hope is that this process limits the number of clarifications needed after discharge, allowing the...Read More »
Q: What is difference between the severity of illness (SOI)/risk of mortality (ROM) in the APR-DRG arena? For example, DRG 280 with APR 190, 4/4, and the individual code SOI/ROM.
Let’s say you have a patient with a ST-...Read More »
Like all reporting structures, CMS updates its Hierarchical Condition Category (HCC) list each year. Recently, version 23 was released, and it contains some notable additions that CDI professionals—whether inpatient or outpatient—should be aware of.Read More »
by Richard Pinson, MD, FACP, CCS and Cynthia Tang, RHIA, CCS
The clinical world now has a new set of criteria for malnutrition, thanks to representatives from the American Society for Parenteral and Enteral Nutrition (ASPEN), the European Society for Clinical Nutrition and...Read More »
When a patient comes into the hospital and, despite the medical staff’s best efforts, dies, the documentation in the record should accurately reflect how truly sick the patient was. Unfortunately, the record frequently depicts a more-or-less healthy patient who came into the hospital and then...Read More »
Q: Our coders often select the principal diagnosis based on how invasive the testing is. For example, a patient comes in with vertigo and hematemesis. For the vertigo, the physician orders a brain CT, IV medications, and an ear, nose, and throat consult. The patient is diagnosed...Read More »
by Cesar M. Limjoco, MD
Sepsis has been defined as a toxic response to infection. Sepsis-1 and Sepsis-2 defined it as a systemic inflammatory response to infection. Sepsis-3 now defines it as life-threatening organ dysfunction caused by a dysregulated host response to infection....Read More »