Thirty-eight hospitals filed a lawsuit against the U.S. HHS on January 18, alleging that that HHS Secretary Alex Azar overstepped his authority when he finalized an OPPS policy that cuts...Read More »
By Jennifer Boles, CPC, CRC
Before starting an ambulatory or outpatient CDI program, those tasked with the project must first create some universal definitions so everyone is on the same page and speaking the same language. Consider asking:
By Ellen Jantzer, RN, MSN, CCDS, CCS, CRC
CDI specialists who have been around for a while might recall how in 2007 CMS implemented the Medicare Severity Diagnosis-Related Group (MS-DRG) system. This variation to the inpatient prospective payment system (IPPS) linked reimbursement...Read More »
Many outpatient CDI professionals stepped into their roles blind—not knowing where to begin or how to tell if they were successful. However, as programs mature, they need to be able to track their progress for a number of reasons, including focusing physician education and justifying continued...Read More »
by Richard Pinson, MD, FACP, CCS, and Cynthia Tang, RHIA, CCS
In response to providers’ complaints of burdensome regulatory documentation, CMS proposed in July 2018 to reduce the number of evaluation and management (E/M) levels to two and reduce documentation requirements for...Read More »
Even on a small scale, knowing where to start with an outpatient CDI program implementation can leave leaders at a loss. Add in the complications of a large healthcare system and things can get even hairier. With multiple sites and teams dispersed geographically, there’s a lot to consider before...Read More »
by Tammy Trombley, RHIT, CDIP, CCDS
Recently, an outpatient CDI review project at a large family practice/internal medicine physician clinic identified numerous coding errors on physician-coded claims. More than half of the errors affected risk adjustment for the CMS-Hierarchical...Read More »
by Tracy Boldt, RN, BSN, CCDS, CDIP, and Ellen Jantzer, RN, MSN, CCDS, CCS, CRC
The rules of compliant query practice do not change based on the setting. We must consider query construction and wording of provider communication with the same eye for compliance as we have...Read More »
