~1~ 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 state! 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 continue. 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 ~2~ 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 registration. “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 now?” 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 http://www.facebook.com/l.php?u=https%3A%2F%2Fpicasaweb.google.c om%2Flh%2Fsredir%3Funame%3D109158911949064418039%26target%3 DALBUM%26id%3D5609691845345757617%26authkey%3DGv1sRgCImt- JTOtNT2wgE%26feat%3Demail&h=27cf8 ~3~ 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 Charrington.email@example.com 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 help! 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. ~4~ If you missed the last meeting and want a copy Beach continued from Page 2 of the speakers’ power points just email me at Virginia.firstname.lastname@example.org 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 email@example.com 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 https://www.facebook.com about or YOU would like to BE a speaker /acdisflorida 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! flacdis.org 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! ~5~ 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 yours. 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. RACMonitor.com. Region C: Connolly, Inc. Region D: HealthDataInsights, Inc. Join our Florida ACDIS group on Facebook ! https://www.facebook.com/acdisflorida 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: Virginia.firstname.lastname@example.org Charrington.email@example.com According to recent released data from CMS, the RAC Kimberly.firstname.lastname@example.org 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 email@example.com www.cms.gov/RAC/Downloads/FFSNews-letter.pdf 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 ~6~ 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 Virginia.firstname.lastname@example.org 2nd Quarter are due by end June Charrington.email@example.com 3rd Quarter are due by end September Kimberly.firstname.lastname@example.org 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 email@example.com Treasurer Kimberly.firstname.lastname@example.org 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! http://newsletters.ahima.org/newsletters/ICDTen/2011/January/Jan_ICD.html 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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