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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

Dr. Welby your documentation in the progress note dated 6/15 indicates the diagnosis of acute respiratory failure, in the presence of a COPD exacerbation. The patient is being treated with 3 liters of oxygen NP and maintaining an oxygen saturation of 93%. Respiratory therapy assessment indicates patient uses home oxygen at 2-3 liters.

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