Q&A: Appeal letters for medical necessity denials

March 13, 2018
CDI Blog - Volume 11, Issue 52
Ask ACDIS, Denials & Appeals, Quality & Regulatory

Q: Our facility does not have a standard appeal letter template to respond to...Read More »

Case Study: A new role for CDI: Appeals and analysis

March 1, 2018
CDI Journal - Volume 12, Issue 2
CDI Expansion, Denials & Appeals, Quality & Regulatory

As the CDI profession matures, programs are instituting career ladders to create advanced positions for seasoned CDI professionals looking for a...Read More »

Radio Recap: DRG validation: CDI and coding collaboration

March 1, 2018
CDI Journal - Volume 12, Issue 2
ACDIS Guidance, Clinical & Coding, Denials & Appeals

“DRG validation can mean many things in many different arenas,” Autumn Reiter, RN, BSN, CCDS, CDIP, CCS, director of CDI staffing...Read More »

Book excerpt: What are the Recovery Auditors anyway?

February 27, 2018
CDI Blog - Volume 11, Issue 42
ACDIS Guidance, Denials & Appeals

Formerly known as Recovery Audit Contractors, the Tax Relief and Health Care Act of 2006 created Recovery Auditors to identify Medicare...Read More »

Q&A: Supplemental medical review contractors

February 20, 2018
CDI Blog - Volume 11, Issue 37
Ask ACDIS, Denials & Appeals, Quality & Regulatory

Q: How does the Supplemental Medical Review Contractor (SMRC) determine which...Read More »

Q&A: Fighting DRG downgrades

February 15, 2018
CDI Strategies - Volume 12, Issue 7
Ask ACDIS, Policies & Procedures, Denials & Appeals

Q: We’ve encountered audit takebacks and denials from a certain payer who...Read More »

ACDIS update: What sepsis criteria are you using?

February 8, 2018
CDI Strategies - Volume 12, Issue 6
Ask ACDIS, Clinical & Coding, Denials & Appeals

Whether it be changing definitions (hello, sepsis-3...Read More »

Q&A: Using your PEPPER for CDI

February 8, 2018
CDI Strategies - Volume 12, Issue 6
Ask ACDIS, Quality & Regulatory, Denials & Appeals

Q: Should CDI have access to the PEPPER?Read More »

News: Medical Center received nearly $1.7 million in overpayments, OIG says

February 8, 2018
CDI Strategies - Volume 12, Issue 6
Denials & Appeals, News, Outpatient CDI, Quality & Regulatory

Medicare incorrectly paid approximately $1.7 million to Carolinas Medical Center in Charlotte, North Carolina, as a result of incorrect billing on...Read More »

Q&A: Coding diagnoses left out of the discharge summary

January 11, 2018
CDI Strategies - Volume 12, Issue 2
Ask ACDIS, Clinical & Coding, Denials & Appeals

Q: According to Official Guidelines for Coding and Reporting, uncertain diagnoses...Read More »

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