Sepsis

Are institutions appealing Sepsis as PDx if the patient meets Sepsis 2 / Super SIRS,  but not SOFA? We have one hospital in our system that uses only Sepsis 2 as their criteria, and many of them have been denied - I have appealed many but so far most have been upheld

. Do I have a leg to stand on? Any luck out there?

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Comments

  • Will need some more information to be helpful. What Payer are you getting the majority of denials from? Are all of those denials regarding a lack of organ failure? Do they specifically reference Sep-3? How many times are you appealing? Are you getting to P2P?

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