Physician Advisor's Corner: The ‘new’ DRG denial strategy

by Trey La Charité, MD

I have previously addressed the issue of auditor denials. However, given the industry changes I have witnessed in the last 12–18 months, it is time to revisit  this problem. And, per communications with colleagues in the CDI world, I suspect the same alarming trends are evident in many facilities. The days of merely maintaining compliance with published coding guidelines are gone. We are in a new era of blatant attempts to purport medical  clairvoyance and supplant decades of accepted diagnostic criteria.