Medical necessity for cardiovascular procedures is the top overpayment issue for three out of the four Recovery Auditors in FY 2013 first quarter (October 2012–December 2012), according to the most recent release of...Read More »
It was hardly explicit that organizations could rebill on an outpatient basis (or fully bill) for services denied as non-medically necessary in an inpatient setting. However, on March 13, CMS issued a...Read More »
"Don’t let the relative quiet fool you,” says James S. Kennedy, MD, CCS, CDIP, president of CDI MD-Physician Champions in Smyrna, Tenn., “there are big changes in this year’s IPPS final rule, changes that represent a paradigm shift in the way CDI programs work.”Read More »
by Trey La Charité, MD
I realized, painfully, early in my career as a physician advisor for CDI that I needed to learn a lot more about coding and the process of translating physicians’ written words into ICD codes. I also needed a more secure footing to successfully appeal the ever...Read More »
by James P. Fee, MD, CCDS, and Garry L. Huff, MD, CCS, CCDS
Certainly, the alphabetical and tabular index of the ICD-9-CM codebook assume the “postoperative” relationship as causal, but a CDI specialist should investigate this further within the specific clinical context.Read More »
