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FEBRUARY 202371- year-old male with history of TAVR, cardiomyopathy, pacemaker, cirrhosis, DM, HTN and chronic vertigo presented with syncope accompanied by vertigo. The patient reported a fall several days earlier, striking head.Day of presentation: 1838: CT head...
Utilization Management and CDI are often discussed in silos, but they shouldn’t be. Impactful transformation happens when data is leveraged from both of these vectors in the clinical revenue cycle to establish a real baseline. Join us for another journey through the Clinical Revenue Cycle from the emergency department to the QIO and beyond.
76-year-old male with a past medical history significant for hypertension, hyperlipidemia , diabetes, chronic atrial fibrillation, and CKD stage 3 presented to the ED with chest pain.Day of presentation: 2332: EKG demonstrates atrial fibrillation with a heart rate 111...
On November 1, 2022, CMS released the CY 2023 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System (ASC) Final Rule with Comment Period (CMS–1772–FC), with the official Federal Register publication scheduled to occur on November 23, 2022. The comment period for the Final Rule will remain open until January 1, 2023.
Utilization Management and CDI are often discussed in silos, but they shouldn’t be. Impactful transformation happens when data is leveraged from both of these vectors in the clinical revenue cycle to establish a real baseline. Join us for a journey through the...
73-year-old male with a past medical history of ventral hernia with 3 prior surgeries presented to ED complaining of worsening abdominal pain with nausea.Day of presentation: 2053: CT demonstrated SBO with thick-walled small bowel loop in ventral hernia. 2218:...
On August 1, 2022, CMS released the FY 2023 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospitals (LTCH PPS) Final Rule (CMS–1771–F), which was finalized and became effective on November 1, 2022.
Join us for an overview of CMS HCC risk adjustment fundamentals for the inpatient clinical documentation specialist and coder. We will review the top ten commonly under-reported diagnoses that map to a CMS HCC, review how risk scores are calculated, impact payment, and benefit from improved clinical documentation and comprehensive coding.
70-year-old male with a past medical history significant for nephrolithiasis, MI, CABG, CVA and DM presented to ED with 1 day history of worsening right flank pain, nausea, vomiting and chills. Seen one day earlier with CT demonstrating a stone in the right mid-ureter...