Forms

June 9, 2020
Hospital inpatient, Hospital outpatient, Questions and answers

Platinum members can access a COVID-19 ICD-10-CM FAQ white paper. If you are not a Platinum member and you want to upgrade your account, please call customer service at 800-650-6787.

May 26, 2020
Hospital inpatient

This sample COVID-19 complications and co-morbid conditions tip sheet was provided to ACDIS by Nicole Newman, MSN, RN, CCDS, CDI coordinator at East Jefferson General Hospital in Metairie, Louisiana. Please note that because of the changing nature of the COVID-19 pandemic, this resource will likely need to be updated and amended as things evolve. Those wishing to adapt this tool should adapt it to their own particular programmatic needs, system requirements, and organizational criteria.

May 20, 2020
Clinical documentation, Hospital inpatient, Hospital outpatient

This sample COVID-19 query was developed by Sharme Brodie, RN, CCDS, CCDS-O, CDI education specialist at ACDIS/HCPro in Middleton, Massachusetts. Should you choose to use this sample, you adapt it to your particular programmatic needs, EHR system requirements, and organizational diagnostic criteria. CDI professionals should also ensure that all the answer options are clinically relevant for the particular patient.

May 12, 2020
Clinical documentation, Hospital inpatient

Platinum members can access a sample COVID-19 physician tip sheet. If you are not a Platinum member and you want to upgrade your account, please call customer service at 800-650-6787.

May 6, 2020
Anatomy and terminology, Hospital outpatient

This crossword puzzle includes medical terminology that coders need to be familiar with to select the most specific CPT codes for spinal surgeries. 

April 22, 2020
Hospital outpatient, Physician practice

The following decision tree will help you decide whether the application of modifier -22 (increased procedural services) would be appropriate in cases where the provider's work exceeded the norm. 

April 15, 2020
Hospital inpatient

Platinum members can access a crossword puzzle featuring ICD-10-PCS codes for extracorporeal or systemic assistance and performance procedures. If you are not a Platinum member and you want to upgrade your account, please call customer service at 800-650-6787.

April 8, 2020
Clinical documentation, Hospital outpatient, Physician practice

Modifier -22 (increased procedural services) frequently causes compliance headaches for revenue cycle professionals. This explanation form may be used to clarify the need for additional reimbursement in complex surgical cases where physician work exceeded the norm.

April 1, 2020
Hospital inpatient, Physician queries

Platinum members can access a sample principal diagnosis query form. If you are not a Platinum member and you want to upgrade your account, please call customer service at 800-650-6787.

March 25, 2020
Clinical documentation

At the time of this resource's publication, COVID-19 has spread to all 50 states including the District of Columbia. To date there have been nearly 500 deaths in the United States and the virus is spreading rapidly. As more people are being tested, the incidence of infection is rising at an alarming rate.

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