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The “art” Clinical Validation - ACDIS

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 are now experiencing a new world Kid in Recovery Auditors Arrived Introduction of the concept of Clinical Validation The game

The process of reviewing physician documentation and determining whether the correct codes and sequencing were applied to the billing of the claim. Review focuses on physician documentation and code assignment in comparison to the Official Guidelines of Coding and …

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acdis.org

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acdis.org

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acdis.org

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acdis.org

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