2025 ACDIS Outpatient Pocket Guide

2025 ACDIS Outpatient Pocket Guide
The essential CDI resource for outpatient professionals

Available January 2025

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 2025 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 industry veteran and former ACDIS Director Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC and James Manz, MD, CCDS-O, a practicing physician at the Mayo Clinic who is steeped in the latest physician documentation terminology the 2025 ACDIS Outpatient Pocket Guide is a winning combination of practical, tailored CDI tips and resources and clinical, regulatory, and coding guidance adapted from the official sources.

The 2025 ACDIS Outpatient Pocket Guide offers the latest information outpatient CDI professionals need to know, including:

• Fiscal Year (FY) 2025 guidelines
• AHA 2024 Coding Clinic guidance
• Version 28 CMS-HCCs
• 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 condition. 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 or condition 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 2025 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.

Reorganized in 2024, it also now includes 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.

Page Count: Approximately 550 + 5 Tabs
Dimensions: 4.5x7 Coil/Spiral
ISBN: 978-1-64535-293-8

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

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About the Authors

Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC, is an experienced CDI subject matter expert, former interim ACDIS director, and former CDI education director at HCPro. While at ACDIS and HCPro, she was also the lead developer and instructor for the CDI Boot Camps as well as a member of the CCDS-O certification committee and the ACDIS Advisory Board; she also frequently spoke on the ACDIS Podcast and at ACDIS conferences and webinars. She is the author of The Clinical Documentation Improvement Specialist’s Complete Training Guide and the ACDIS Pocket Guide series. Prescott has served in a variety of health systems and settings since joining the nursing profession in 1985 and she developed and implemented a CDI program in 2007.

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.

About the Reviewer

Jessica Vaughn, DNP, RN, NEA-BC, CCDS, CCDS-O, CRC, is a nurse of 28 years with 14 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.