Posts by Norwood Staffing
Eight frequently misdiagnosed conditions can be rectified with good CDI, coding practices
By Brian Murphy What conditions are most frequently misdiagnosed, leading to patient harm? A study by the general internal medicine team at Brigham and Women’s Hospital and Harvard Medical School in Boston (yay, my backyard! No Harvard jokes please) found that 1 in 14 general medicine patients (7%) experience harm from diagnostic errors.…
Read MoreRemote patient monitoring sees huge utilization increase, but corresponding regulatory spotlight
By Brian Murphy Remote patient monitoring has incredible potential to improve the health of our population… but many providers aren’t billing it correctly, raising the specter of inappropriate utilization or fraud, waste, and abuse. Remote patient monitoring is the use of devices (think blood pressure cuffs, CPAP machines, insulin pumps, etc.) that a…
Read MoreUsing POA as the Guiding Star for CDI: Insights from Yale New Haven Health
Between MS-DRGs, HCCs, U.S. News and World Report rankings, Leapfrog, readmissions, mortalities, Vizient or Premier performance, and on and on, how does a CDI program know where to focus its record reviews? The choices seem bewildering. My current guest on Off the Record Leif Laframboise has settled on present on admission (POA) as the…
Read MoreNew pediatric respiratory failure white paper published for CDI specialists
By Brian Murphy Pediatric clinicians (of which I’m definitely not one, but I listen well) will frequently tell you: Children are not just little adults. That goes for clinical criteria used to diagnose pediatric conditions, and associated CDI and coding work. And in particular, respiratory failure. I was very glad to see…
Read MoreEmpathy meets AI: Rhoda Chism on Human-Machine Harmony in CDI
Listen to the complete episode here. With 23 years and counting in CDI, Rhoda Chism has seen a lot. The rise of new regulations and reimbursement mechanisms, and the advent of new technologies that have radically transformed chart reviews. Rhoda has not only weathered these changes and navigated the turbulent waters, but remains…
Read MoreAI arms race escalates battle of healthcare denials
By Brian Murphy Are we headed for a healthcare AI arms race? A hellish AI dystopia? Some days I wonder. I was reading a breathless interview with the chief technology officer of a revenue cycle management technology company. The CTO states: “Think of genAI as giving coders superpowers. It’s helping them…
Read MoreOIG audits of risk adjustment diagnoses running into familiar, repetitive roadblock—and resolution is needed
By Brian Murphy “Additionally, Humana did not agree with our audit methodology or overpayment estimation methodology.” Take the above line from the OIG’s latest audit report, remove “Humana.” Fill in the blank with another payer. The result is the same. No Medicare Advantage (MA) payer agrees with the OIG’s audit methodologies. …
Read MoreNorwood partnership allows physician group to focus on optimal patient care
A large physician group responsible for more than 175,000 lives across 300 locations doesn’t have a lot of time for self-reflection. Nor should it. Its focus is where it needs to be—providing care for a range of complex patients across more than 30 specialty services. But when it realized its quality scores and reimbursement…
Read MoreLiving in Denial(s) with Karen Elmore, BJC Healthcare
Listen to the program here. Karen Elmore is living in denial(s). Her job as Senior Clinical Documentation Quality Coordinator for BJC Healthcare involves a daily battle against a never-ending tide: Payers denying diagnoses on the perceived basis of lack of clinical support. Recently she’s had to deal not only with human payers, but…
Read MoreYet another reason to implement Annual Wellness Visits into your CDI/coding efforts
Detection of early cognitive decline the latest benefit of covered Medicare/Medicare Advantage service By Brian Murphy Medicare Annual Wellness Visits (AWVs) are an important piece of patient wellness and appropriate capture of acuity/severity of illness. But they’re also underutilized. You can now add another reason why you should be working to use them as a…
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