I'm interested in tge document as well. Will you please email me a copy to: Samanthasalgado46@gmail.com
I am also interested. Please email it to me at email@example.com. Thank you.
Jessica M Smith, RHIA, CCS
I also would be interested in hearing what other facilities are doing. We are having DRG revisions, especially with Medicaid, for Sepsis, ABLA and Acute Respiratory Failure. We code what the physician uses for the diagnosis but then Medicaid doesn't think the diagnosis is supported by the documentation. We have discussed this briefly during Medical Staff Meeting without resolution. I don't feel comfortable questioning their diagnoses without some guidelines. Thanking everyone in advance.
Robin Sewell CCS CPC CHTS-PWMedical Liaison Services LLC 772-546-1414
Glad to hear you are also from Kansas as I have several questions with Medicaid's DRG revisions. I recently read an article that credential coders are not always required. There can be exceptions to the requirement which wasn't part of the article. My questions are: Is a physician involved in denying a diagnosis? Is only criteria used? Are credential coders used 100% of the time? Will Medicaid "share" their criteria with providers?