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                                                                                                          June 2011
                                                                                                    Volume 2, Issue 3

         CDI Focus
                                                            INSIDE THIS ISSUE
From the President                                          From the President                                      1
By Virginia Bailey                                          RAC Review                                              1
                                                            ACDIS National Conference Update                        2
                                                            Last Meeting Jupiter Medical Center May 20              2
 This 4th Annual ACDIS Conference in Orlando last           Mentors Corner                                          3
April was just spectacular!                                 Next meeting August 20 in Pensacola                     4
                                                            Renewal of Dues Information                             6
                                                            Free ICD 10 Info from AHIMA                             6
I have had the good fortune to be able to attend
the last 3 conferences and they get better every
year! I wish we all could attend each one but life
being what it is not everyone can. In spite of that
Florida had 93 CDI’s attend-the largest from any

Pre-conference night 15 or so of our members &
others from Florida met for dinner & networking
at Disney . It was nice to put names to faces!

 With 3 tracks to choose from there was
something for everyone to learn and great
networking opportunities! And ACDIS chose one
lucky attendee and presented them with FREE
attendance to the 2012 Conference. You can’t                The TRIVIA CONTEST, created by Pam Long and Charlie Morell ,

beat that!                                                  was presented by Charlie Morell, Florida Chapter VP. This 1st
                                                            ever contest was a big hit and is now an annual event at the
                                                            conferences! Each year a different state Chapter will host.

RAC Review               by Kimberly Richert
                                                        Surgical Acute Care Hospitals. The majority of
 Topping the charts for RAC Denials first               medical necessity denials reported were for 1 day
                                                        stays, in the “wrong setting”. (Not that the care was
 part of 2011- Lack of Medical Necessity
                                                        medically unnecessary), but that the “care could
                                                        have been given in a less intensive setting.” These
Data gathered from the RAC Trac survey for the
                                                        were patients that were statused as InPt, and CMS
America Hospital Association (AHA) finds in the
                                                        argues, they could have been “Observation” pt’s.
first quarter for 2011 that the “Lack of Medical
                                                        The Right care is what we all; So let the appeals
Necessity is the Top reason for denial claims by
Recovery Audit Contractors (RACs).”
                                                        Yes, the best thing you can do for your facility -

Most RAC activities occur in General Hospitals and
                                                        Please see RAC Review on page 5

Update on the 2012 ACDIS 5th Annual Conference
ACDIS annual conference
May 10-11, 2012 * Manchester Grand Hyatt                 for updated information on hotel rates, Poster
                                                         Application, Planning Committee application.
Planning has begun for the 5th Annual ACDIS              Start planning NOW to go-get your groups of 5
Conference at the Manchester Grand Hyatt in San          or 10 together to take advantage of the “every
Diego, CA. 2012 promises to be better than ever          5th person FREE”. Save NOW-put a little aside
with new tracks of exciting sessions, the annual         each pay and attend if you can!!!
awards luncheon, poster presentations, local
chapter networking opportunities, and other              And remember Poster presenters & Planning
special events. Keep checking the ACDIS website          Committee members get ½ off their

 “Another Day in Paradise” Jupiter FL May 20th

  There was no lack of enthusiasm at our last            With everyone’s interest at fever pitch Cathy
meeting at Jupiter Medical Center on the East            Cover, Mgr RAC Denial Team at Morton Plant
Coast of Florida! We had one new member join us-         Hosp led us into “Sink or Swim: Surviving the
welcome Donna McCormack!                                 RAC Attack”. Dr Mark Michelman Physician
                                                         Advisor MPM Healthcare finished the joint
Special thanks and KUDO’s to Cathy Hamilton and          presentation. This took us into overtime with
her CDI team for graciously hosting such an              many questions and everyone left wanting
informative and FUN meeting! Many comments we            more information! We will have to invite them
received stated the same and more about how well         back to another meeting!
the meeting went!
                                                         Continued: Please see Beach on Page 4
Margi Brown, consultant, presented “Blending
Denials into the CDI Mix”. This piqued the groups
interest and moved us into “what can happen

Cortnie Simmons from K force Healthcare
presented “Translating ICD 9 to ICD 10 for
Common Diagnosis”. The members were really
involved with many questions on how can we get
more info on the transition as it is fast
approaching!                                          Go to Florida ACDIS Facebook Page for more photos or use this link

                The Mentor’s Corner
         An ongoing chapter in each newsletter written by YOU-send any great ideas you would
             like to share in the next quarterly newsletter to
                                                                      and CDI program reminders with
                                                                      administrative support.
                                                                     A good way to jump in and get involved
                                                                      is to become involved in the Florida
                                                                      Chapter Leadership. Elections are
                                                                      coming up soon and current officers are
                                                                      more than happy to mentor those with
                                                                      an interest who wish to hold an office.
                                                                      There is a lot to learn, networking
   Electronic health record implementation may
                                                                      opportunities abound and it looks great
    have affected your physician response rate.
                                                                      on your resume! Don’t be shy, we will
    You may need to try to enlist the help of
    others to remind the physicians to respond to
    the queries. Perhaps you have a marketer                         Challenge yourself. As Glenn Krauss
    who already visits the physicians and can                         wrote in an National ACDIS blog June 20,
    bring queries with him/her?                                       2011, ask yourself:
                                                                      “How can I make this job more
    If the physician is no longer going into the                      interesting?”
    paper chart and you still have paper queries,                     “What additional areas can I incorporate
    is there a place that you can leave queries,                      into my present duties?”
    such as a folder for their review/completion?                     “What new responsibilities can I tackle
    A unit secretary desk, the Medical Records                        that will make the position more
    office, their mailbox, somewhere they go                          valuable to me personally, as well as to
    daily?                                                            the organization and co-workers I
    Call or visit the physician office and get to                     interact with?”
    know the office manager. They will partner                        “What other areas can I see myself
    with you to make sure the physician’s LOS,                        potentially growing into as I advance my
    CMI and SOI numbers reflect the patients they                     career?”
    treat. Fax queries to the office manager and
    have them help facilitate a response.                            Network with local CDIs. You don’t have
                                                                      to wait for quarterly meetings. Arrange
    It may help to identify your physicians that
                                                                      to have dinner & troubleshoot barriers
    have high volume admissions and target them
                                                                      together. We are fortunate that our
    one by one to determine the best way to get
    them to respond. Physician response rates                         Florida Chapter members are more than

    seem to ebb and flow depending on what                            happy to share their best practices. It
    other initiatives are being implemented and                       helps to know you are not an island.

                                                  If you missed the last meeting and want a copy
Beach continued from Page 2                       of the speakers’ power points just email me at
We had the usual Raffles with several
educational materials from ACDIS/HCPRO
given away along with several fun beach
bags full of goodies, sand pails and
buckets and large sun hats and let’s not
forget about the cooler filled with all
kinds of extras!

Three CEU’s toward your CCDS renewal
were also awarded as well as 3 Nursing
CEU’s. What a bonus!                                  Joan, Cathy and Sharon our gracious hosts!

“Meet Me at the Clin Doc Fair” August 20th

   Many thanks to Penny Cassady for hosting           Start making plans now to attend. We will be
our next meeting on Saturday, August 20th             sending out a list of hotels in the area soon along
from 9am to 3:30 pm at Sacred Heart in                with the theme!
Pensacola, FL. It will be our first meeting in
the Panhandle of Florida so all you members           As soon as all the speakers and events are confirmed
from North Florida finally will be close to           we will be sending out the Agenda and Invite to
home!                                                 everyone

Our theme is a State Fair-Corn Dogs, Sausage          We encourage you to bring your colleagues whether
and Peppers, Cotton Candy and Blue Ribbon             they are members or not. (Non members are free 1st
prizes. We will be planning a Best Pie Contest-       time, $10 for CEU’s.) Bring a few Physicians, PA’s or
everyone bring your favorite homemade pie             ARNP’s! Please RSVP to
and the winner gets a Blue Ribbon and a prize.
We all get to judge-yummy!

                                                                  Join our Florida ACDIS group
We are lining up the speakers so if anyone has
                                                                         on Facebook !
a particular subject they would like to hear
about or YOU would like to BE a speaker
please e-mail Penny or Virginia. Any and all
                                                                  Visit us at our new Website:
ideas are welcome! We would like 3 speakers
so let us know soon!                                            

                                                                  It’s still under construction
CCDS CEU’s will be awarded. A trivia contest                        but it’s up and running!

and lots of great things to raffle and giveaway
as always!

              Rac Review con’t from page 1                                  **********************************

                                                                Identifying the Recovery Auditors Geographric Area
             is to appeal- appeal –appeal. Use your
           physician advisors, all documentation                 Each Recovery Auditor is responsible for identifying
           and the medically necessary reasons for              overpayment and underpayments in approximately ¼ of
           keeping the patient as an “InPt” and you             the country. See below for a link to the Recovery Audit
           can help keep your facility afloat. Don’t            Program Jurisdiction Map.
           sink or swim with the sharks. Fight
           back with everything you did for the                 The Recovery Auditor in each jurisdiction is as follows:
           patient, show the proper care was given
                                                                Region A: Diversified Collection Services (DCS)
           and the recoupment, payment will be
                                                                Region B: CGI
           For more information on the details of the survey,
           please see article “Top reasons for RAC Denials”,
           Carol Spencer, BA, RHIA, CCS CHDA.
                                                                Region C: Connolly, Inc.

                                                                Region D: HealthDataInsights, Inc.

Join our Florida ACDIS group on Facebook !
Friend us and the National ACDIS page!

Lots of good information on both!

Feel free to contact any of the officers
for any questions or suggestions
you may have:                            According to recent released data from CMS, the RAC                                    program has recovered $162 million in overpayments for
                                                                the first quarter of 2011. In return, CMS has returned
or our new Chapter Email :                                      $22.6 million for the accounts overturned.
                                                                For a more detailed review for RACs, please visit

FYI to our RN Membership:
The Florida Board of Nursing has adopted the position of the ANCC with an effective date of June 1, 2011
The following courses will cease to offer continuing education renewal credit as of June 1, 2011
        CPR/AED certification and re-certification courses
        Basic Life Support (BLS) certification and re-certification courses
        Advanced Cardiac Life Support (ACLS) re-certification courses
        Neonatal Resuscitation Program (NRP) re-certification courses
        Pediatric Advanced Life Support (PALS) re-certification courses
         For more information check with the Florida Board of Nursing

                   Dues Renewal Information and General Information

                                                              Renewal of Dues
Join our Florida ACDIS group on Facebook !

Friend us and the National ACDIS page!

Lots of good information on both!
                                                              Dues are renewed quarterly

Feel free to contact any of the officers                If you joined in the :
for any questions or suggestions
you may have:                                           1st quarter of the year you are due by the
                                                        end of March                             2nd Quarter are due by end June                    3rd Quarter are due by end September                            4th Quarter are due by end December
                                                        A list with the date you joined is attached to
or our new Chapter Email :                              the email. Or you can contact our Secretary                                  Treasurer for
                                                        your due date.

 ICD 10 information from the AHIMA Website :

 (Author Cortnie Simmons was a speaker at our last meeting. This is from an ongoing FREE
 Newsletter you can subscribe to on the AHIMA website. Go to the link below to subscribe!

 Disease of the Eye and Ear

 By Cortnie R. Simmons, MHA, RHIA, CCS

 While the last article we discussed the musculoskeletal system, this article will be discussing diseases of
 the eye and ear. The eye and ear are two of the most complex sensory organs. The eye is composed of
 structures that are not only related to vision but other sensory organs as well. The ear is made up of
 structures that are involved with hearing, sound wave conduction, balance and equilibrium. In this
 article we will discuss some of the key A&P elements that surround both the ear and eye that take place
 with ICD-10.

 ICD-10 Chapter Restructuring

 In ICD-10, disease and disorders of the eye and ear are located in two new chapters. Chapter 7 (H00-
 H59) was added specifically for Disease of the Eye and Adnexa, and Chapter 8 (H60-H95) was created
 specifically for the Diseases of the Ear and Mastoid Process. In ICD-9 diseases and disorders from both
 the eye and ear where found within Chapter 6: Diseases of the Nervous System and Sense Organs. This
 reorganization represents a great improvement; coding professionals will now be able to logically locate
 all diseases and disorders of the eye or the ear within their specific chapters. This is one of the great
 benefits to the ICD-10 system- it is more logically enhanced for coding professionals.

 Read more.

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