criteria for certain dx

Tara.Lebeck

Our CDI program is in the process of creating standardization criteria for certain Dx, such as hyponatremia/hypernatremia, ABLA, ect in which we would code.  Do any other programs have standardization re: this, If so how did you come up with criteria to base it upon.  Do you use that when you send denial information to insurances?  What other Dx. to you use standardization process criteria for?  Is there any other helpful information or resources you could direct us to.

thanks

proddy@clarionhospital.org

We are doing something similar also.  We are a teaching hospital and one of my frustrations is that some attendings use different parameters for determining Acute vs Chronic Kidney disease, Respiratory failure, Malnutrition, etc. This creates inconsistency with the medical students/interns, etc.  We are choosing 4 or 5 diagnoses and developing a statement of definition or guideline that will be approved at medical staff meeting.  I'm hoping this will help with documentation education as well as a useful reference to cite in an appeal setting

deana.grant@uky.edu

Would you be willing to share this information?  We would also like to find one for cardiogenic shock as well.  Thank you

cynthia.mead@nahealth.com

We are trying to get our physicians to agree to institutional standards/definitions that are evidenced based, but it is a slow process.

We are trying to get our physicians to agree to:

 Sepsis 3 criteria ...ie sepsis is an infection with acute organ dysfunction

AKI based on KDIGO criteria

Malnutrition based on ASPEN/AND criteria

Acute respiratory failure based on criteria listed by Dr. Pinson

We're focusing on high risk denial diagnoses.

Good luck,

Cynthia