Denial Engines

A HIT blogger’s term for the Recovery Audit Contractors (RAC).
See this post for more information on Denial Engines.
Speaking of RACs, I heard of a RAC denial (excisional debridement challenge) for a patient with SIRS/sepsis, respiratory failure, ARF, septic shock, etc. LOS over 50, DRG moved from 541 to 542. You get the picture. Almost $100,000 [...]

Quetelet, BMI and ICD

Here’s an interesting bit from my Atom/RSS feed associated with a standing Pubmed search for ICD-9-CM. Nice summary of how we got to BMI (Note: V850 or V854 are CCs in the MS-DRG grouper).
So if you don’t use Atom or RSS feeds, try it out. This means the internet comes to you (by [...]

RAND Addendum

In case you missed it, the RAND addendum, Evaluation of Severity-Adjusted DRG Systems, was posted a few weeks ago. Evaluation confirms that the availability of MS-DRGs (public vs. proprietary), the “new” CCs and other factors make this the preferred choice over other severity systems.
Seems like alot of work for a concept that was first hatched [...]

C&M Agenda

We’re just days away from the C&M meeting in Maryland. I liked it better when the meetings were in D.C. at the HHH building. There’s just something about being in the capitol that made the trip more interesting. The “new” DHHS building is a bit sterile. Also no wireless available (probably a homeland security requirement). [...]

21st Century Coding Advice and Guidelines

It’s time to move coding guidelines and advice into the 21st century. We live on the web now – wikis, blogs, RSS, del.icio.us, . . . the list is endless. But my IP coding advice still gets published quarterly and seldom meets the needs of the coding community. Same problem for “official” coding guidelines [...]