An urgent issue: How admit type can skew quality metrics

Listen to the episode here.   I’m recently back from the 2025 ACDIS national conference, and as usual flush with the latest in CDI trends, education, and breaking news. And right at the top of my takeaways is a seemingly innocuous classification with big ramifications: admit type. What makes this a big deal? Some hospitals…

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Assigning codes from clinicians other than the patient’s provider

By Brian Murphy One of the hard truths about medical coding is that codes can only be assigned based on documentation from the patient’s provider. More specifically, a qualified physician or other practitioner who can be held legally accountable for rendering a patient’s diagnosis. This rule undoubtedly is a source of frustration and even provider…

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Complying with Medical Record Documentation Requirements

CMS published a valuable and (surprisingly) easy to read fact sheet relevant to anyone in the mid-revenue cycle.  Link to “Complying with Medical Record Documentation Requirements” below, along with a handy ACDIS recap. The fact sheet lays out four common sources of denial related to insufficient documentation. CDI, coding, and compliance professionals, take note. The…

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Social Determinants of Health (SDOH), integral to preventive medicine and cost reduction, in jeopardy under new CMS administration

By Brian Murphy Health is far more than just biology, pathophysiology, or medical facts about a patient. Non-medical factors influence health outcomes, including the conditions into which people are born and live. Think about housing instability, lack of access to care, poor food security, and (un)employment. Today we call these social determinants of health (SDOH).…

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