jwmorris1

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jwmorris1
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  • I’ve seen this documentation at numerous organizations & wondered if all the Neo’s went to a conference and learner to document this or does it have something to do with UR criteria.  I’ve seen inadequate intake and feeding difficulties docume…
  • m1ghtymurs3 said: We query the attending. Agree
  • Hi Maggie!  I was always taught not to code, and have had outside auditors agree, if within that “normal” postictal period. I always looked to validate the dx of encephalopathy if it extended time, additional resources started being extended beyond …
  • I think the Psychiatric dx should be the PDX as SI is most likely a manifestation of the underlying Psych dx.  Jeff
  • hootstown said: Good Afternoon, I’m hoping I can get some clarification on the process of how CDI works.  I’m working on a project at work and we are discussing how CDI specialists accomplish their goal of improving documentation.  Code…
  • Agree with Paul on #1 and #2. I have seen Md's document that regardless of negative cultures or findings they are going to treat as that condition or document it as presumed. I think if you have such a statement from your MD's that you go ahead and …
  • evanspx@sutterhealth.org said: As others have so accurately stated, if the Surgeon wants his or her risk-adjusted data to be accurately compared and reported in the public domain, it is vital that all pertinent risk factors  and secondary condi…
  • A Physician Advisor or CMO should step in and have this conversation. Yes, the MD's pro fee billing is separate and that's usually all they worry about. But, if they want a new Davinci robot, OR expansion, additional equipment, etc... they need to c…
  • Yes, it would be a CPT code that the MD submits for their professional services. In the case of normal postoperative vent weaning there would not be an associated ICD-10 CM diagnosis. Now, if weaning is unsuccessful and the patient remains on the ve…
  • Their critical care E/M code should cover weaning and show their work.
  • short answer--RDS is basically considered the most severe form of respiratory failure in the newborn due to surfactant deficiency...similar to ARDS in an adult. Clinically, if you have a premature baby with respiratory failure it's almost always due…
  • lprescott1 said: interesting- perhaps we need to submit to coding clinic. I am wondering if the original poster ever heard back from coding clinic on this one. Thanks, Jeff
  • There's a discussion here that might help https://forums.acdis.org/discussion/comment/19784#Comment_19784
  • Was just about to reply to this when Paul's response popped up. Generally gel foam embolizations are done to occlude blood vessels as part of tx for liver CA like Paul stated. I could only see a patient getting a gel foam embolization s/p liver bi…
  • Per the code book I110 is used and then an additional code is needed to identify the type of heart failure. If I110 meets the definition of a PDX then yes, it can be used.
  • bbogda@morrishospital.org said: If all of what jwmorris1 said is true, but the doctor is saying 'meets sepsis criteria' in progress notes,  I would make sure that 'sepsis' is included on the discharge summary. My response was answering …
  • If they truly meet sepsis criteria, have a known or suspected infection and were appropriately treated for said infection. 
  • The progression of a pressure ulcer during a hospital stay requires two codes 1 for the pressure ulcer that was POA and 1 for the progression of the pressure ulcer POA N. I would definitely talk to the wound care nurses and providers to determine if…
  • The guidelines state based on provider documentation Assignment of the final character for trimester should be based on the provider’s documentation of the trimester (or number of weeks) for the current admission/encounter. This applies to t…
  • What effects did those previously treated STD’s have on the childbirth? At what point were they treated? Any additional antibiotics given during childbirth or during labor?  Would be similar to a patient havjng a UTI 4 weeks prior to delivery succe…
  • jillian.bisbe said: I'm wondering- should they even be billing for critical care time since they don't truly have respiratory failure? I'm not an E/M expert but I would think that it would be appropriate since they are managing a criti…
  • Expected ventilator management Years ago MD's were taught that they needed a dx to bill for their critical care time and that's where this practice started. This should be highly discouraged for the reasons you mentioned. I think there are many d…
  • Your Infection Prevention Practitioners will not report it out as such because they are abstracting the record and it doesn't meet criteria. But, Coding and CDI have two choices--1) Code it or 2) Query/clinically validate. Once a diagnosis has bee…
    in CAUTI Comment by jwmorris1 March 2019
  • If you are auditing for a compliant query and the query is compliant (remember all reasonable choices should be provided and only reasonable choices) then the query is compliant. If you want to take it to another level and determine if the query i…
  • Just curious...what's different about NY State regs? Are there additional privacy laws surrounding PHI?
  • Agree with Aimee— No, I would not use the first code you listed. This code is for use for cardiac output assistance with devices such as balloon pumps or Impellar devices and will most likely change your DRG. I would definitely use the manual CPR co…
  • Septic shock is a manifestation code and should not be sequenced as the PDX. From the Official Coding Guidelines Septic shock (a) Septic shock generally refers to circulatory failure associated with severe sepsis, and therefore, it repres…
  • I guess technically it's "other" but just curious if there were indicators for a more specific code? Jeff
  • I am guessing the patient is currently in house? Has the UTI been ruled in or out? Not much you can do for a stage 1 pressure ulcer except turn the patient and keep them clean...not really a good reason for admission to inpatient care. I'd think the…