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The “art” Clinical Validation

The art Clinical ValidationLAURIE L. PRESCOTT RN, MSN, CCDS, CDIPAHIMA APPROVED ICD-10 CM/PCS TRAINERCDI EDUCATION SPECIALIST HCPRO, A DIVISION OF BLRO bjectives Discuss the impact of Recovery Auditors/Private Pay Audits as related to Clinical Validation Define Clinical Validation vs DRG Validation Define the term Clinical indicators Discuss the use of Clinical indicators in query practice Construct queries to obtain missing/vague diagnoses Construct queries when there is no Clinical support for a documented diagnosesBack in the Provider documented a diagnosis We did not question validity of diagnosis We coded the diagnosis We got paid A new dimension has been

digestive disorders ... compliance, and HIM staff) to review cases submitted by CDI and coding staff when diagnoses are inconsistent with the patient’s clinical picture, or the clinical picture is inconsistent with the diagnoses. The committee can

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