Major Complications/Comorbidities (Audio Conference)

AUDIOCONFERENCE ON CD OR AUDIO ON-DEMAND

Sponsored by Briefings on Coding Compliance Strategies

presented on May 21, 2008

CMS’s new Medicare Severity-DRG (MS-DRG) program, launched last October, continues to throw challenges at coding staff. Clinicians need to clearly document complications/comorbidities (CCs) and major CCs (MCCs) so that the complete picture of the patient’s condition can be accurately coded and billed. HIM, coding, quality, case management and clinical documentation integrity staff need the clinical acumen and training and support to be able to recognize CCs, MCCs, and other pertinent diagnoses when they appear in the record. If both halves of the puzzle don’t come together, you risk compliance and threaten the bottom line by leaving money on the table.

Don’t risk compliance or your hospital’s financial health. This 90-minute audioconference helps you understand MCCs under the MS-DRGs system, including conditions like sepsis, hypertension, and chronic kidney disease, how to recognize them in the medical record, and—when necessary—how to how to query physicians for additional information.

An MS-DRG with a MCC pays at the highest level. But MCCs can be tough to capture without the right documentation, and without it, you can’t code or bill for it. Our speaker discusses several of the most problematic CCs and MCCs and their clinical conditions as well as potentially undocumented CCs and MCCs. They also discuss strategies to ensure appropriate physician documentation.

Note: This is an intermediate-level program. Purchasers should have a basic understanding of MS-DRGs and APR DRGs.

TAKE A LOOK AT THE AGENDA:

1. How CMS determines whether a secondary diagnosis is a non-complication/comorbidity (CC), CC, or major CC (MCC) 
1. Use of previous claims data
2. The role of physician documentation in establishing CCs and MCCs
2. Major MCC capture: Pathophysiology of disease                         
1. Progression of diagnoses from non-CC to CC to MCC
2. Differentiating chronic from acute conditions
3. Recognizing MCCs in the medical record
4. Use of literature in physician education
5. Review of problematic MCCs, including

• Congestive heart failure (acute vs. chronic, systolic vs. diastolic)
• Altered mental status (acute delirum vs. encephalopathy)
• Bacteremia/sepsis/septicemia
• Hypertension (uncontrolled vs. accelerated vs. malignant)
• Angina (not otherwise specified vs. accelerated vs. MI)
• Chronic kidney disease (stages vs. end-stage renal disease)
• Malnutrition (not otherwise specified; mild, moderate, severe)
• TIA/stroke

3. Querying techniques: How CDI specialists should approach the physician

A question and answer sessions follows the presentation.

LEARNING OBJECTIVES

At the conclusion of this audioconference, you will be able to:

• Describe a clear pathophysiological approach to CCs and MCCs
• Identify and apply conditions to a medical record
• Explain documentation from a physician’s perspective
• Define the major MCCs under the MS-DRG system
• Implement a strengthened approach to the querying process
• Explain how CCs, MCCs, and non-CC conditions work

FEATURED SPEAKER

James S. Kennedy, MD, CCS, is a director in the FTI Healthcare group of FTI's Corporate Finance practice and is based in Brentwood, TN. His expertise includes physician and hospital leadership, healthcare systems improvement, healthcare documentation and coding compliance, and government relations.

CONTINUING EDUCATION CREDITS

This program has been approved for 2 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA)

BONUS MATERIAL INCLUDED IN YOUR MATERIAL PACKET!

In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials and:

• Resource list of articles that can support compliant querying and pathophysiological approach to clinical documentation
• Sample “Minute for the Medical Staff” articles from Medical Records Briefing

These materials are provided with PDF links.

WHO SHOULD LISTEN?

HIM managers and coders; clinical documentation improvement (CDI) staff; physician advisors to case management, coding staff, and clinical documentation specialists; case managers; professional providers; chairman of quality committees; VP of medical affairs; finance, IPPS revenue cycle professionals, CFOs; and compliance officers.

AUDIO ON-DEMAND

In addition to the regular purchase options for HCPro audioconferences, we are pleased to offer another option, an audio on-demand. Audio on-demand allows you to download the program and play it back at your convenience through your computer or MP3 player. Purchase a CD or audio on-demand of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.

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