by Sharme Brodie, RN, CCDS

I recently had the privilege of working with some pretty impressive people in our Boot Camp course, who happen to work for some critical access hospitals (CAH). They’re learning what they can do to improve documentation in the medical record, demonstrate the good quality of care provided to their patients, to increase severity of illness and risk of mortality (SOI/ROM) while improving profiles for their facilities and physicians, and, of course, to improve reimbursement. 

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There are 1,974 additions, 311 deletions, and 425 revisions for the 2017 ICD-10-CM code set, according to a statement published by CMS. The resulting total of 71,486 diagnosis codes was released by the Centers for Disease Control and Prevention (CDC) on June 24.

The backlog of Medicare appeals could be cleared by 2021, according to a proposed rule released by CMS and the U.S. Department of Health & Human Services on June 28.

The fiscal year (FY) 2017 IPPS proposed rule included some significant changes to Patient Safety Indicator (PSI) 90, one of which is a new name: The Patient Safety and Adverse Events Composite. A fact sheet recently released by the measure's owner, the Agency for Healthcare Research and Quality (AHRQ), provides insights into what may lie ahead if the proposed rule's content is finalized.

Q: I am with a CDI program that is starting to explore the severity of illness/risk of mortality (SOI/ROM). I personally have been reviewing for SOI/ROM for quite a while. I usually designate the impact (MCC/CC/SOI/ROM) after the billing is done and see if what I queried for made a final impact, and only take credit for those that do.I was told that regardless of the actual final impact on SOI/ROM we should be taking credit for any SOI/ROM clarification as SOI/ROM impact. Which is the most accurate, “correct” way to capture the CDI impact for these types of clarifications?