No matter how thorough the documentation, no matter how precise the coding, denials still haunt the halls of most facilities. While many facilities have a denials department handling all appeals, others incorporate physician advisors and CDI professionals into the equation. Differing...Read More »
Some eligible professionals (EP) and group practices will get a pass for failing to meet 2016 Physician Quality Reporting requirements (PQRS) due to incomplete updates to ICD-10 code sets, CMS announced January 11.
CMS decided not to apply negative payment adjustments to EPs and group...Read More »
“Even if you don’t have a title, you can be a leader if you’re passionate and have a desire to change a process that’s not working,” said Judy Schade, RN, MSN, CCM, CCDS, CDI specialist at the Mayo Clinic Hospital, on the May 18 Quarterly Conference Call. She spoke in regard to...Read More »
Despite CDI programs’ 10-plus years of existence, physician engagement continually ranks as the number one concern for CDI departments, according to the 2017 ACDIS Membership Survey. Part of this challenge may stem from the fact that, although some methods work better than others, physicians are...Read More »
Q: I encountered clinical validation issues where documentation noted a diagnosis with criteria, but the criteria used didn't meet the definition. For example, noted sepsis with criteria of tachycardia and increased white blood cell (WBC) count. But, the patient’s heart rate (HR...Read More »
A number of inpatient prospective payment system changes in recent years, due primarily to the Affordable Care Act, have allowed CMS to adjust healthcare reimbursement based on quality metrics and data. But some providers are unaware that many quality scores for themselves and hospitals are...Read More »
In its 2013 position paper, “Electronic Health Records and the Role of the CDI Specialist,” members of the ACDIS Advisory Board addressed several concerns related to challenges and opportunities emerging with the advent of electronic systems. Among them were how to handle copy-and-paste concerns...Read More »
