2023 CDI: The Villains in Hospital Denials: Clinical Validity & Conflicting Documentation [IEM]

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This module identifies specific clinical documentation education needs and provides provider education for optimal documentation.

For further study:

Medicare.gov

2020 ACDIS Pocket Guide. Laurie Prescott, RN, MSN, CCDS, CDIP, CRC, CCDS-O, James Manz, MD, CCDS-O

2020 ICD-10-CM for Hospitals/Payers Expert

AHIMA. “Clinical Validation: The Next Level of CDI.” Practice Brief update, January 2019.

Diagnostic criteria reference: Kaynar, A. M. (2018, July 25). Respiratory Failure. Retrieved from https://emedicine.Medscape.com/article/167981-overview.

Madan, A. (2017). Correlation between the levels of SpO2 and PaO2. Lung India, 34(3), 307-308. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427770/

Target Audience

Physicians, Advanced Practice Providers, and Residents of the BSWH system.

Learning Objectives

After participating in this activity, the learner should be able to:

 

  • Define the interplay between common EMR errors and hospital denials.
  • Review the meaning of clinical validation.
  • Outline where the common areas of conflicting documentation exist. 
  • Identify the support needed to validate a diagnosis
Course summary
Available credit: 
  • 0.25 AMA PRA Category 1 Credit
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 0.25 Attendance
Course opens: 
03/30/2023
Course expires: 
03/31/2025

Planners/Authors:  This activity was planned, reviewed, edited, and approved for use as the curriculum for the Baylor Scott & White Health organization by:

Elizabeth Aguirre, MD,
Clinical Documentation Improvement Program
Inpatient Clinical Documentation Physician Lead

Sheila Walker
Director of Coding Education

Melissa Koehler
Reviewer-Coding

Claire Isbell, MD
Review #1

Sameera Vohra, MD, MPH
Review #2

Kevin Chang, MD
Review #3

Disclosure of Relevant Financial Relationships:

*This content is not related to products or business lines of an ACCME-defined commercial interest

**There are no relevant financial relationships with ACCME-defined commercial interests for anyone who was in control of the content of this activity.

Accreditation: The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation: The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health, designates this enduring material activity for a maximum of 0.25 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.25 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit

CME Provider Privacy Policy & Contact Information: The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health observes privacy and confidentiality of CME information and personal information of CME participants. Third parties receive only aggregate data about CME activities that are relevant to their interests and/or the activities they support.

Address:  A. Webb Roberts Center for Continuing Medical Education Of Baylor Scott & White Health Dallas, Texas 75246

Phone:  Dallas – 214-820-2317

Phone:  Temple – 254-724-7609

Website:  BSWH.md/CME

Available Credit

  • 0.25 AMA PRA Category 1 Credit
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 0.25 Attendance
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