Set yourself up for appeal success with knowledge about the legitimate presentations of acute heart failure, the common vulnerabilities that auditors identify, the challenges clinical teams face, and how to write a concise and compliant validation query.
You’ve heard it and seen it all before – there is still a great deal of confusion surrounding what is, and what isn’t, acute heart failure. The result: a lot of clinical inconsistency that puts a target on acute and acute on chronic heart failure for payor DRG validation and clinical validation, and an even closer auditor eye on hospitals and their justifications for reimbursement. Without a standardized approach to definition and queries, hospitals will continue to inconsistently address the validity of acute heart failure documentation and coding.
The good news: You’re not alone – our presenter, physician, and health information management (HIM) expert Dr. Beth Wolf, will help you cultivate the skills needed to write a concise and compliant validation query, therefore championing your facility’s processes surrounding heart failure validation and setting you and your facility up for success! You will walk away with actionable knowledge about the legitimate presentations of acute heart failure, the common vulnerabilities that auditors identify, and the challenges clinical teams face from a boots-on-the-ground coding and documentation authority.
Coders rely on the clinical and CDIS teams to have accurate, complete and compliant documentation that supports the diagnosis of acute heart failure. Knowledge of legitimate presentations of acute heart failure, the common vulnerabilities that auditors identify, and the challenges clinical teams face will help coders know when and how to issue a post discharge validation query.
Coders, Clinical Documentation Integrity Specialists, physician advisors, health information management professionals, auditors