Respiratory Failure
Hi All,
We just recently became involved in clinical indicator denials (FINALLY!!!) and I have a question about one I am working on. We have a denial for respiratory failure in which the patient's highest 02 requirement was 4L NC and had documented RA sats in the 80's. We have no ABG's drawn. She ended up being discharged on 2 liters and the insurer is stating that the resp failure was not acute but rather chronic in nature and doesn't meet criteria for ARF (despite documentation by the MD).
I am wondering if this is one I should attempt to fight? And if so, under what definition of resp failure? We do not have institutional definitions (yet).
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
We just recently became involved in clinical indicator denials (FINALLY!!!) and I have a question about one I am working on. We have a denial for respiratory failure in which the patient's highest 02 requirement was 4L NC and had documented RA sats in the 80's. We have no ABG's drawn. She ended up being discharged on 2 liters and the insurer is stating that the resp failure was not acute but rather chronic in nature and doesn't meet criteria for ARF (despite documentation by the MD).
I am wondering if this is one I should attempt to fight? And if so, under what definition of resp failure? We do not have institutional definitions (yet).
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404