Articles

CDI Journal - Volume 17, Issue 5

Guest column | The anatomy of a clinical validation appeal

September 1, 2023
Denials & Appeals

by Kellie Halsted, MSN/MHA, RN, CCDS, CCM

When I became a CDI specialist, I did not foresee myself being someone who would be writing clinical validation appeals. Historically, as a utilization review case manager, I generated medical necessity denials based on my chart review...Read More »
CDI Strategies - Volume 17, Issue 5

Local chapter update: How can ACDIS support your chapter? Read the current services available!

February 2, 2023
ACDIS Guidance, Education

Local chapter leaders have a lot on their plate, and ACDIS is here to help! As you may note in the 2023 ACDIS chapter agreement form, ACDIS offers a list of services to support its chapters and their...Read More »
CDI Journal - Volume 17, Issue 5

Guest column | Promoting authenticity in a team environment

September 1, 2023
Denials & Appeals

by Buddy Morgan-Kraft, BSN, RN

Presenting your authentic self is a key factor in reaching personal and organizational success. In CDI, we have great opportunities to promote authenticity on our teams. The ability to present your authentic and genuine self has many benefits,...Read More »
CDI Journal - Volume 17, Issue 5

Case study | Getting on the same page: Clinical validation, committees, and criteria

September 1, 2023
Denials & Appeals

by Joshua Raposa

Clinical validation denials are those in which a payer denies a claim based on the grounds that the coded diagnosis (or diagnoses) did not meet the clinical criteria for that condition. CDI professionals involved in appealing these denials often complain that...Read More »
CDI Journal - Volume 17, Issue 5

Guest column | Nutrition assessment documentation: Current practice and opportunities for education

September 1, 2023
Denials & Appeals

by Peggi Guenter, PhD, RN, FASPEN, Allison Blackmer, PharmD, BCPS, BCPPS, FCCP, FASPEN, Ainsley Malone, MS, RD, CNSC, FAND, FASPEN, Kris M. Mogensen, MS, RD-AP, LDN, CNSC, Wendy Phillips, MS, RD, NWCC, FAND, FASPEN, and Laurie L. Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC

...Read More »
CDI Journal - Volume 17, Issue 5

Guest column | Maternal mortality and morbidity: Where CDI can help

September 1, 2023
Denials & Appeals

by Julian Everett, MHA, BSN, RN, CCDS, CDIP

Maternal mortality and morbidity are critical issues that continue to affect the healthcare industry worldwide. As a nurse with over 20 years of experience in various healthcare settings, including adults, neonatal, and high-risk...Read More »
CDI Journal - Volume 17, Issue 5

Physician advisor's corner | The crucial role of physician documentation in maximizing revenue cycle performance

September 1, 2023
Denials & Appeals, Physician Advisors

by Timothy Brundage, MD, CCDS

In the ever-evolving landscape of healthcare, physician documentation has transcended its traditional role of capturing clinical care and has become a linchpin of the revenue cycle process. As healthcare organizations face increasing pressures to...Read More »
CDI Journal - Volume 17, Issue 5

Meet a member | ‘I love exactly what I’m doing’

September 1, 2023
Denials & Appeals

Amanda M. Palacios, MPH, RHIA, is the system HIMS director at Riverside Health System in Newport News, Virginia. She has been in the CDI field for 11 years and is an active member of the ACDIS CDI Leadership Council.

ACDIS: What did you do before entering CDI, and...Read More »

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