Q: How do you sequence ESRD, HTN, CHF, and diabetes when the patient is admitted with kidney disease which has progressed to ESRD and requires initiation of dialysis this admission? The heart failure is chronic. The ICD-10 combination code takes you...Read More »
Recently, I was asked an interesting question about querying for the diagnosis of encephalopathy. The student asked whether it was required for a patient to return to their mental status baseline prior to the CDI specialist querying the...Read More »
By Howard Rodenberg, MD, MPH, CCDS
When my son was in middle school, I would call him every evening to review the school day. I would want to know all about the things he was learning and the friends he was making, and he would grudgingly oblique me with a one-word answer if he...Read More »
ICD-11 reflects critical advances in science and medicine and is the first code set revision to be well integrated with EHRs and information systems, the WHO says.Read More »
By Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS
As I sat down to summarize the proposed fiscal year (FY) 2019 ICD-10-CM update, the number of changes are significantly less than the prior two years which makes me think we’re getting back to the norm of expected yearly...Read More »
A common theme that plays a critical role in portraying the patient encounter accurately in both the inpatient and outpatient environments is complete and precise documentation. General principles of medical record documentation...Read More »
