Most facilities find acute respiratory failure to be a commonly denied diagnosis. Sharme Brodie, RN, CCDS, CCDS-O, explores when the circumstances of admission and the focus of care support the condition for coding.
Without proof that services rendered were medically necessary, third-party payers are unlikely to approve claims for reimbursement. With tips from Shelley C. Safian, PhD, RHIA, CCS-P, COC, COC-I , medical coding professionals can use ICD-10-CM codes to prove medical necessity. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Shelley C. Safian, PhD, MAOM/HSM/HI, RHIA , explains ways administration can establish an organizational culture of legal and ethical responsibilities to maintain compliance and honor patients and staff.
Nancy Reading, RN, CPC, CPC-P, reviews the Phoenix Sepsis Score, a new set of clinical parameters to define and diagnose pediatric sepsis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The success of coding and CDI departments depends on collaboration with multiple entities. Laurie L. Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , illuminates how to promote healthy partnership.
JoAnn Baker, CCS, CPC, COC , defines sepsis and septic shock, and delves into the emerging initiative to integrate AI into the diagnosis and treatment process.
Kathy Dorich, MSN, RN, CCDS, CPHQ , explains two types of DRG reconciliation processes that she has implemented to alleviate conflict between coding and CDI departments.
Managing chronic conditions requires involvement from many parties, making documentation challenging. Assess how to improve documentation and reimbursement for chronic conditions with tips provided by Arta Kelmendi-Doko, MD, PhD . Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Merle Zuel, RN, CCDS , explains how healthcare leaders can improve in their roles by understanding all coding and clinical data available and knowing how to analyze it.
Pressure injuries, which can lead to a patient safety indicator (PSI), require clear documentation and coordination among coding, CDI, and clinical departments. Katherine Siemens, RN, BSN, CMSRN, CCDS , evaluates how poor coordination could result in a PSI being incorrectly reported.
Educating clinical staff on proper documentation of mechanical ventilation can avoid compliance issues and support accurate reimbursement. This article clarifies the complications of reporting mechanical ventilation in ICD-10-PCS.
The pediatric population is smaller and involves different clinical and nuances, but this often-underdeveloped area of coding can be a source of missed revenue if left uninvestigated.
Kate Siemens, RN, BSN, CMSRN, CCDS , offers tips on how coders and CDI can assess patient safety indicators to improve reporting accuracy and increase quality of care.
This article explains the quality metrics of hospital-acquired infections and accidental punctures and lacerations, and details how collaborative efforts can reduce these risks.
TaraJo Vaught, MSN, RN, CCDS , shines a light on the crucial roles played by coding and CDI specialists, compares their respective realms, and offers insights for transitioning between them.
Although every professional may be different, there are a few tricks of the trade to building the right garden and letting your CDI department show off some of that natural talent.
Penny Jefferson, MSN, RN, CCDS, CCDS-O, CCS, CDIP, CRC, CHDA, CRCR, CPHQ , explains how professional development in CDI is a journey, demanding integration of specific knowledge, continuous learning, and adaptability.
April Russell, MBA, CPC, CPC-P, COC, CRC, CCDS-O , and Will Morriss, CCS, CCDS-O , describe how artificial intelligence (AI) has impacted providers, coders, and the healthcare industry.