With guidance from three certified medical professionals, CDI specialists and coders can learn how to fight against the overwhelming tide of clinical validation denials by promoting strong documentation, capturing clinical pictures with appropriate codes, and justifying treatment plans.
Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP, explores common reasons for sepsis-related denials, offers strategies for effective documentation and coding, and presents approaches to successfully appeal these denials.
Our experts answer questions on coding COPD, smokers’ cough, and rectal fistulas in ICD-10-CM as well as provide recommendations for addressing malnutrition denials depending on the diagnosis criteria used (GLIM or ASPEN).
Coders are more aligned with CDI specialists than they may realize, as a deeper understanding of coding conventions enhances the accuracy and specificity of documentation. Sydni Johnson, BSN, RN, CCDS , and Suzanne Santellanes, BSN, RN, CCDS , shed light on how the tools of coders play a pivotal role in improving compliance strategies and ensuring the integrity of clinical records.
Denials continue to be a pain point and significant challenge for every hospital across the nation, but Angelica Cage, MBA, BSN, RN, CCDS, CCS, CDIP , provides denial-proofed queries to show how establishing a diagnosis that is strongly supported by the available clinical evidence can reduce or eliminate clinical doubt with respect to the treated condition.
Whether the discussion is about reimbursement, quality metrics, patient outcomes, or CC/MCC capture rates, the whispers of risk adjustment have grown to a roar. Jennifer Brettler, DO, FACP, CHCQM-PHYADV , reveals just how much risk adjustment plays a role in documentation and coding integrity, impacting patient care.
Our experts answer questions on the new ICD-10-CM serotonin syndrome code, key takeaways for documenting and supporting malnutrition diagnoses, and appropriate circumstances for reporting codes from ICD-10-CM subcategory E66.8- (other obesity).
Successfully managing inpatient stay denials should begin long before they occur and depends on having excellent case management, CDI, and coding departments. Although these departments have differing duties, Cathy Farraher Nakhoul, RN, BSN, MBA, CCM, CCDS , shows how they all play a part in ensuring that the final coded data is compliant and accurate.
The majority of U.S. healthcare organizations struggle with denials and underpayments in all care settings, making it difficult to keep up with a meaningful manual appeals process. Learn how coding professionals can leverage technology to accurately capture and validate clinical data, ensuring proper coding and documentation while reducing the likelihood of denials. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
With advice from three certified medical professionals, CDI specialists and healthcare providers can develop relationships that foster a culture of collaboration and continuous improvement in documentation and coding practices.
The majority of U.S. healthcare organizations struggle with denials and underpayments in all care settings, making it difficult to keep up with a meaningful manual appeals process. Learn how coding professionals can leverage technology to accurately capture and validate clinical data, ensuring proper coding and documentation while reducing the likelihood of denials.
The decision to implement AI in one’s health system is no small matter, but Katie Parsley, MSN, RN, CCDS, CPHQ, a CDI manager at Providence Health and Services in Oregon, shows how technology solutions employed at her organization have had an overall positive impact on clinical accuracy, prioritization, querying, and the efficiency of CDI staff.
Our experts answer questions on linking cellulitis and diabetes, coding COPD and associated conditions, and applying clinical criteria guidelines for sepsis.
With advice from three certified medical professionals, CDI specialists and healthcare providers can develop relationships that foster a culture of collaboration and continuous improvement in documentation and coding practices.
Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP, explores common reasons for sepsis-related denials, offers strategies for effective documentation and coding, and presents approaches to successfully appeal these denials.
Amid the myriad of conditions and diseases, probable catheter-associated bloodstream infections emerge as a focal point for clinical intervention and revenue cycle efficiency. Pooja Patwal, MBBS(MD), CCS, CDIP, CHCQM , explores how capturing accurate ICD-10 codes for probable BSIs is paramount for healthcare facilities striving for excellence in patient outcomes.
Chronic conditions pose significant challenges to individuals and healthcare systems alike, often leading to reduced quality of life, increased healthcare costs, and rise in mortality rates if left unmanaged. Proper documentation of chronic conditions, however, can help facilitate communication, coordination, and continuity of care for patients from healthcare providers. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Gain unique and fresh insights from clinical documentation integrity professionals in unique settings to help you strengthen your organization’s denials management efforts.
Organizations need to decide how to manage the clinical validation conundrum effectively and consistently. Trey La Charité, MD, FACP, SFHM, CCS, CCDS, explores one denial prevention tactic that has proved most effective for his organization.
