Note from the instructor | Let’s get DEEP

by Deanne Wilk, MPS, BSN, RN, CCDS, CCDS-O, CCS

Back in the late 1980s and early 1990s, the provider would document the medical conditions of the patient on orange-colored, paper-thin, double-copied attestation sheets. These conditions were submitted to the insurance company only after we attached the little colored tag to the sheet and the provider gave us their signature. We did not question the validity of the conditions or ask for clinical support. We had never heard of MEAT (Monitor, Evaluate, Assess, Treat) at that time. Diagnoses were accepted and paid for based on the provider’s documentation stating that they were present. As we know, however, costs rose, and the Inpatient Prospective Payment System (IPPS) was implemented to ensure patient care occurred in a cost-effective manner.