January 14, 2020
Looking at Possible ICD-10-CM Clinical Coding Challenges in 2020
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…
December 10, 2019
I’m in a New York State of Sepsis
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…
October 1, 2019
Does using SIRS to diagnose sepsis improve mortality?
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…
September 17, 2019
The Controversy Continues: When Sepsis is Not Sepsis
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…
August 13, 2019
All Sepsis as currently defined should trigger SEP-1
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.…
March 26, 2019
SIRS, Sepsis, and Rule No. 1
Semantics aside, clinicians must recognize sepsis and treat it aggressively, to save lives. A few weeks ago, I had a fascinating discussion with Tim Brundage, a physician friend, and fellow clinical documentation improvement (CDI) expert, my co-chair on the American College of Physician Advisors (ACPA) CDI committee, and I’d like…
February 5, 2019
How New York Hospitals Rely on Sepsis-2
Which definition of the deadly condition will be applied in the Empire State has been a hot topic of late. EDITOR’S NOTE: The following is partial transcript of remarks made by Dennis Jones during a recent RACmonitor-produced Monitor Mondays broadcast. First, let me remind everyone that I am in the…
January 29, 2019
Payers and Clinicians Should use Clinically Accepted Criteria when Diagnosing Sepsis
The accurate diagnosis of sepsis is not for DRG assignment. There has been quite a bit of controversy stirred up by UnitedHealthcare (UHC) and its approach to sepsis, and since I am wrapping up a fascinating targeted sepsis project, I want to share what I have learned with you. I…
October 23, 2018
Details of Sepsis-3 Definition Revealed
The biggest holdout to Sepsis-3 is still CMS. UnitedHealthcare has announced that it will be adopting the Third International Consensus Definition for sepsis and septic shock for all of its lines of business, effective Jan. 1, 2019. This definition is better known as "Sepsis-3." The announcement is significant because it…
