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Navigate critical issues faced by CDI professionals

Clinical Validation Reviews for CDI Professionals

Clinical Validation Reviews for CDI Professionals tackles the nuances of a critical concern for CDI professionals and provides expert guidance for meeting challenging chart reviews head-on.

With government auditors frequently denying claims due to lack of clinical indicators for documented diagnoses, CDI professionals are left asking whether they should simply code a clinically unsupported diagnosis or query the physician. While the answer may seem clear, querying can lead to productivity reductions, additional education outreach, and a call for broader policies governing query escalation and reconciliation.

This brand-new book leverages its authors’ expertise to help CDI professionals effectively and efficiently navigate these issues during a necessary query process. By understanding clinical validation concerns, CDI staff can become better translators and storytellers—clarifying the medical record without appearing to question the physician’s medical judgment.

What does this new resource offer?

Develop a clinical validation record review process
Research and develop hospital- or facility-specific clinical criteria for high-volume diagnoses such as sepsis, congestive heart failure, and malnutrition
Apply recent recommendations from the Association of Clinical Documentation Improvement Specialists and the American Health Information Management Association related to compliant query practice and clinical validation efforts
Collaborate with various departments to develop effective clinical validation processes
Conduct successful physician education related to clinical validation
And more!

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