CMS has responded to concerns associated with this issue. As usual, Dr. Ronald Hirsch is making more work for me! He saw an article on sepsis and knew I, and you, my audience, would be interested, so he brought it to my attention (Litell JM, Guirgis F, et. al., Most…
The patient story is paramount to validating a diagnosis of sepsis. MS-DRGs 872 and 871, Septicemia or Severe Sepsis with MCC and without MCC, respectively, are problematic, from a compliance and reimbursement perspective. Most commercial payers, including Medicare Managed Care organizations, have put these two MS-DRGs under heightened scrutiny due…
Sepsis is diagnosed through clinical judgment. One of the forums I monitor recently saw a question about sepsis and SEP-1, which elicited this article. SEP-1 is the Hospital Inpatient Quality Reporting Program measure titled “Severe Sepsis and Septic Shock: Management Bundle.” The issue that Dr. Todd Brown raised was that…
In practice, doctors may use these terms synonymously. We are in the midst of a COVID-19 global pandemic that is changing the world as we know it. Most COVID-19 patients may not need acute inpatient care admission. Only the sickest will. These are the patients who undergo a cytokine storm…
Seven coding challenges reveal a new compliance landscape in 2020. It’s here: 2020! This past year in healthcare, as in many years before, was full of changes, challenges, and some surprises as well. When trying to foresee the key future challenges in clinical coding, the following topics came to mind…
Sepsis is a clinical diagnosis, and clinicians should be permitted to make the diagnosis appropriately. When I step up onto my sepsis soapbox, people often refer to New York State and tell me how they are not allowed to accept Sepsis-3, pursuant to state regulation. Full disclosure: I hail from…
The criteria and definitions for sepsis are presented to help medical staff better understand sepsis. I popped on LinkedIn to repost the details of the Centers for Medicare & Medicaid Services (CMS) listening session regarding complication and comorbidity (CC) and major CC (MCC) comprehensive analysis after a recent edition of…
Electronic alerts for systemic inflammatory response syndrome (SIRS). EDITOR’S NOTE: Dr. Erica Remer reported this story live during the Sept. 24 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. Dr. Ronald Hirsch recently brought an article to my attention, and I felt compelled to share…
If there is no organ dysfunction, it is not sepsis. EDITOR’S NOTE: Dr. Erica Remer reported this story live during the Sept. 10 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. Apparently, I am not done pondering and pontificating about sepsis, which is apropos, considering…
All sepsis now is the condition formerly known as severe sepsis. EDITOR’S NOTE: Dr. Erica Remer reported this story live during the Aug. 13 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. I’m the co-chair of the American College of Physician Advisors CDI Education Subcommittee.…