2024 ACDIS Outpatient Pocket Guide: The essential CDI resource for outpatient professionals

CDI professionals need a day-to-day reference when conducting their outpatient medical record reviews—one that can provide trusted clinical indicators for compliant and effective physician clarifications, and at-a-glance, easy-to-use diagnosis and Hierarchical Condition Category (HCC) references. The 2024 ACDIS Outpatient Pocket Guide is the essential resource for outpatient coding guidance, HCC updates, compliant query best practices and standards, E/M requirements, and diagnostic definitions.

Co-written by ACDIS’ interim director and CDI education director Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC; James Manz, MD, CCDS-O, a practicing physician at the Mayo Clinic who is steeped in the latest physician documentation terminology; and Tamara Hicks, BSN, MHA, RN, CCS, CCDS, CCDS-O, director of clinical documentation excellence at Atrium Health Wake Forest Baptist, the 2024 ACDIS Outpatient Pocket Guide is a winning combination of practical, tailored CDI tips and resources; helpful references including ICD-10-CM code mappings organized by HCC; and clinical, regulatory, and coding guidance adapted from the official sources.

The 2024 ACDIS Outpatient Pocket Guide offers the latest information outpatient CDI professionals need to know, including:

• Fiscal Year (FY) 2024 guidelines
• AHA 2023 Coding Clinic guidance
• Version 28 CMS-HCCs
• Expanded neoplasms section that now addresses solid tumors, leukemia, and lymphomas
• New provider tips from James Manz, MD, CCDS-O of Mayo Clinic
• Icons designed to assist you in easily identifying conditions with specific considerations:
• A toad icon indicates that that a TOAD status code may need to be reported with this HCC. TOAD is a quick mnemonic that can be used to remind providers to capture Z codes related to conditions such as Transplants, Ostomies, Amputations/AIDS and Dialysis Status.
• A caution icon indicates that this HCC infrequently occurs in the outpatient setting; therefore, if it is listed as a diagnosis, it may have been inadvertently carried over from a recent/past hospitalization and used on a postadmission visit.

The 2024 ACDIS Outpatient Pocket Guide also covers the transition from CMS-HCC Version 24 to Version 28. In Version 28, certain conditions now require additional specificity, including heart failure and neoplasms, and the ACDIS Outpatient Pocket Guide has expanded these sections to provide CDI specialists with this key information.

Additionally, this latest edition has been updated to incorporate Version 28 CMS- HCCs and reorganized to include conditions that do not impact CMS-HCCs but are commonly seen in the outpatient setting and impact other risk adjustment methodologies. Each condition section begins with an easy-to-reference table describing the impact of the condition within different risk adjustment methodologies including the Elixhauser Comorbidity Index, HHS-HCCs, and Healthcare Effectiveness Data and Information Set (HEDIS) measures. 

Published: January 2024

Page Count: 560
Dimensions: 4.5x7 Coil/Spiral
ISBN: 978-1-64535-275-4

For bulk orders and discounts, please contact us at information@hcpro.com or 800-650-6787.

About the Authors

Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC, is the ACDIS interim director, education director, the lead developer and instructor for the CDI Boot Camps, and a member of the CCDS-O certification committee and the ACDIS Advisory Board. She is a frequent speaker on the ACDIS Podcast, at ACDIS conferences, and in webinars. She is the author of the Clinical Documentation Improvement Specialist’s Training Guide and the ACDIS Pocket Guide series.

James Manz, MD, FAAOS, CCDS-O, is a consultant in spine and neurological surgery with the Mayo Clinic Health System as well as assistant professor of healthcare administration. Manz serves as physician chair of the Mayo Enterprise Outpatient CDI Subcommittee, physician vice chair of the Mayo Enterprise Inpatient CDI Subcommittee, and physician chair of the Mayo Clinic Problem List Stewardship Committee. Manz is also a member of the CCDS-O subcommittee of the ACDIS Certification Committee.

Tamara Hicks, BSN, MHA, RN, CCS, CCDS, CCDS-O, is the director of clinical documentation excellence (CDE) at Atrium Health Wake Forest Baptist (AHWFB) in Winston-Salem, North Carolina, where she is responsible for the enterprise CDE department at AHWFB’s five campuses. She was one of the original staff when AHWFB rolled out its clinical documentation integrity (CDI) program in 1999, and since then she has participated in building and expanding the program by educating staff and faculty, providing leadership, promoting departmental goals, and coordinating department operations. She is a member of the American Health Information Management Association (AHIMA) and the Association of Clinical Documentation Integrity Specialists (ACDIS), where she served as a founding member of the ACDIS Advisory Board and the Certified Clinical Documentation Specialist (CCDS) Certification Board. She was reelected to serve on the ACDIS Advisory Board in 2016. In 2019, she earned the CDI Professional of the Year award from ACDIS.

About the Reviewer

Jessica Vaughn, DNP, RN, CCDS, CCDS-O, CRC, is a nurse of 26 years with 12 years of CDI experience, having led one of the nation's first ambulatory CDI programs. She has spoken at multiple conferences, authored articles, received ACDIS' Recognition of CDI Professional Achievement Award, and helped write both the original study guide and the initial CCDS-O certification exam. Vaughn has held certifications in oncology, chemo and biotherapy, and as an AHIMA-Approved ICD-10-CM/PCS Trainer. She completed her Doctor of Nursing in executive leadership at Duke University and believes in empowering interprofessional healthcare teams to improve patient care.