Clinical & Coding

Natalie Sartori, MEd, RHIA, AHIMA Approved ICD-10-CM/PCS Trainer, and Rebecca A. “Ali” Williams, RN, MSN, CCDS, present ways to expand CDI efforts to include the specific documentation needed for ICD-10-PCS code assignment. This presentation helps CDI professionals recognize additional ...

Christine Block, RN, BSN, explains the significance of documentation related to SOI/ROM in the oncology service line. It demonstrates how teaching results in more specific documentation, which in turn leads to more accurate coding. The presentation explains how to identify opportunities directed...

Andrew Rothschild, MD, MS, MPH, presentation explores how CDI specialists and coders are taught not to question a physician's clearly documented diagnosis. But what happens when that diagnosis seems to have come from left  field? Specialists and coders are also bound to clarify apparent...

Brent Hadder, MD, explores the ICU where multiple issues involving multiple organ systems and diagnoses occur simultaneously. He shares strategies implemented at the University of Iowa to improve surgical ICU documentation and coding. Hadder illustrates how a practicing physician and...

William Haik, MD, FCCP, CDIP, AHIMA Approved ICD-10-CM/PCS Trainer, and Garry L. Huff, MD, CCS,  CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer, discuss updated clinical validation guidelines of acute kidney injury, sepsis, and malnutrition.

Angela Kertz, RN, and Karen Newhouser, RN, BSN, CCDS, CCS, CCM, presentation includes an easy-to follow, light-hearted analogy on choosing the most appropriate principal diagnosis. The proper "driver"  ensures the CDI professional is capturing the maximum benefit by assisting with precise...