CDIP 무료 덤프문제 온라인 액세스

The facility has received a clinical validation denial for sepsis. The denial states sepsis is not a clinically valid diagnosis because it does not meet Sepsis-3 criteria. The facility has a policy stating it uses Sepsis-2 criteria.
What is the BEST next step?

• A.Have the contracting department work with payors to obtain agreement on how sepsis will be clinically validated.
• B.Appeal the denial because all payors must use the hospital's sepsis criteria when reviewing their claims.
• C.Remove sepsis from all claims where the diagnosis is not supported by sepsis 3 criteria.
• D.Query physicians when Sepsis-3 criteria is not met so they can provide additional documentation to support the diagnosis.

The clinical documentation integrity (CDI) manager is meeting with a steering committee to discuss the adoption of a new CDI program. The plan is to use case mix index (CMI) as a metric of CDI performance.
How will this metric be measured?

• A.Over time with a focus on high relative weight (RW) procedures that impact these procedures on overall CMI
• B.Over time with a focus on particular documentation improvement areas in addition to the overall CMI
• C.Month-to-month to show CMI variability as a barometer of a specific month
• D.Month-to-month and focus on patient volumes to determine the raise the overall CMI

Which of the following should be examined when developing documentation integrity projects?

• A.Physician satisfaction surveys
• B.CC and MCC capture rates
• C.Query rates from coding staff
• D.Coding productivity statistics

An 86-year-old female is brought to the emergency department by her daughter. The patient complains of feeling tired, weak and excessive sleeping. The patient's daughter comments that patient's mental condition has not been the same. Lab results are unremarkable except for a sodium level of 119, a BUN of 22, and a creatinine of 1.35. The patient receives normal saline IV infusing at 100 cc/hr. The admitting diagnosis is weakness, altered mental status and dehydration. Which of the following queries is presented in an ethical manner thus avoiding potential fraud and/or compliance issues?

• A.Patient is feeling tired, weak, sleeping a lot and has altered mental status. Sodium is 119 and she is on NS IV at 100 cc/hr. Is the altered mental status related to the sodium of 119?
• B.Patient's sodium is 119 and she is on NS IV at 100 cc/hr, is this clinically significant? If so, please document a corresponding diagnosis related to this lab result.
• C.Patient's sodium is 119 and she is on NS IV at 100 cc/hr, does patient have hyponatremia?
• D.Patient is feeling tired, weak, sleeping a lot and has altered mental status. Sodium is 119 and she is on NS IV at 100 cc/hr, please clarify the clinical significance of the lab result.

A 70-year-old severely malnourished nursing home patient is admitted for a pressure ulcer covered by eschar on the right hip. The provider is queried to clarify the stage of the pressure ulcer. Because the wound has not been debrided, the provider responds "unable to determine".
How will the stage of this pressure ulcer be coded?

• A.Unstageable pressure ulcer
• B.Undetermined stage pressure ulcer
• C.Stage IV pressure ulcer
• D.Stage III pressure ulcer