Author Description

The Physician Advisor's Guide to Clinical Documentation Improvement Trey La Charité, MD James S. Kennedy, MD, CCS, CDIP Physician advisors are not just needed for case management anymore. ICD-10-CM/PCS and the changing landscape of healthcare reimbursement make their input invaluable in the realm of CDI and coding, too. This book will help your physician advisors quickly understand the vital role they play and how they can not only help improve healthcare reimbursement, but also reduce claims denials and improve the quality of care overall. This book will: Provide job descriptions and sample roles and responsibilities for CDI physician advisors Outline the importance of CDI efforts in specific relation to the needs and expectations of physicians Highlight documentation improvement focus areas by Major Diagnostic Category Review government initiatives and claims denial patterns, providing physician advisors concrete tools to sway physician documentation Table of Contents CDI Foundation Team composition Staff responsibilities Core competencies Program structure Risk and severity adjustments Data sources Risk of mortality and secondary diagnoses Physician Compare Provider profiling Payment models Bundled payments MS-DRGs/APR-DRGs HCCs Value-based purchasing HACs/POAs E/M Coding foundations Transition to ICD-10 Cooperating Parties Examples of increased specificity Coding guidelines as they apply to CDI Coding Clinic influence Query compliance Evolution of query practices Effective query creation Auditing/monitoring queries Clinical conditions Stroke Altered mental status Encephalopathy Funct