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Diabetes and hypertension have evolved as two of the modern day epidemics affecting millions of people around the world. These two common co-morbidities lead to substantial increase in cardiovascular disease, the major cause of morbidity and mortality of adults around the world. In Diabetes and Hypertension: Evaluation and Management, a panel of renowned experts address a range of critical topics -- from basic concepts in evaluation and management of diabetes and hypertension, such as dietary interventions, to evaluation and management of secondary hypertension in clinical practice. Other chapters focus on high cardiovascular risk populations such as those with coronary heart disease, chronic kidney disease and minority patients. In addition, evolving concepts and new developments in the field are presented in other chapters, such as prevention of type 2 diabetes and the epidemic of sleep apnea and its implication for diabetes and hypertension evaluation and management. An important title covering two of the most troubling disorders of our time, Diabetes and Hypertension: Evaluation and Management will provide the busy practitioner with cutting edge knowledge in the field as well as practical information that can translate into better care provided to the high-risk population of diabetics and hypertensive patients.
First Steps in Outpatient CDI: Tips and Tools for Building a Program Anny P. Yuen, RHIA, CCS, CCDS, CDIP Page Knauss, BSN, RN, LNC, ACM, CPC, CDEO Find best practices and helpful advice for getting started in outpatient CDI with First Steps in Outpatient CDI: Tips and Tools for Building a Program. This first-of-its-kind book provides an overview of what outpatient CDI entails, covers industry guidance and standards for outpatient documentation, reviews the duties of outpatient CDI specialists, and examines how to obtain backing from leadership. Accurate documentation is important not just for code assignment, but also for a variety of quality and reimbursement concerns. In the past decade, outpatient visits increased by 44% while hospital visits decreased by nearly 20%, according to the Medicare Payment Advisory Commission. However, just because physicians are outside the hospital walls doesn't mean they're free from documentation challenges. For these reasons, CDI programs are offering their assistance to physician practices, ambulatory surgical centers, and even emergency rooms. This book will explore those opportunities and take a look at how others are expanding their record review efforts in the outpatient world. This book will help you: Target the outpatient settings that offer the greatest CDI opportunities Understand the quality and payment initiatives affecting outpatient services Understand the coding differences between inpatient and outpatient settings Identify data targets Incorporate physician needs to ensure support for program expansion Assess needs by program type
Population and Health in Developing Countries: Volume 1. Poulation, health, and survival at INDEPTH sites
The Complete Guide to CDI Management Cheryl Ericson, MS, RN, CCDS, CDIP Stephanie Hawley, RN, BSN, ACM Anny Pang Yuen, RHIA, CCS, CCDS, CDIP Managing a CDI department can be a daunting task for new and seasoned managers alike. The Complete Guide to CDIManagement provides CDI program managers and directors with insight into the most common issues associated with implementing, staffing, running, and growing a CDI department. The book also covers core skills such as auditing and metrics, and it provides strategies for overcoming challenges related to electronic records, changing regulatory landscapes, and resource limitations. The Complete Guide to CDI Management incorporates the deep expertise of multiple authors with varied backgrounds who have come together to share their firsthand knowledge. From reporting structures and productivity measurement to defining a mission and physician engagement, this definitive resource addresses the wide array of issues facing CDI managers and directors in today's hospital environment. Table of Contents About the Authors Introduction Chapter 1: An Introduction to CDI for the New Manager History of Coded Data The Medical Coder The Prospective Payment System Adding "Severity" Into the DRG Methodology CDI Basics Summary Chapter 2: Growing a CDI Department The Traditional Role of CDI CDI Review Population Principal Diagnosis Assignment Types of DRG Reviews Quality Focus Summary Chapter 3: Developing Relationships Sharing the Mission Physician Engagement Obstacles to Developing a Physician Relationship Leveraging Queries as an Educational Tool The Art of Clinical Validation The Query Format Query Templates Fostering a Relationship With Coding Networking Summary Chapter 4: Department Structures and Staffing Expectations Department Structures Staffing/Hiring Physician Advisor Creating a Career Ladder Continuing Education CDI Department Meetings Evaluations Credentialing Initialing vs. Revitalizing Summary Chapter 5: Demonstrating the Return on Investment Measuring Success Productivity and Sample Metrics Summary Chapter 6: Challenges and How to Overcome Them Organization Issues Resource Issues Summary Appendixes Appendix A: Resources
The RAC Toolkit for Hospitals and Health Systems: Manage Responses and Avoid Claims Under the Permanent Program Amanda W. Berglund, MS, MBA; Elizabeth E. Lamkin, MHA Learn how to respond to RAC audits. And more importantly, how to prevent them. The RAC Toolkit for Hospitals and Health Systems: Manage Responses and Avoid Claims Under the Permanent Program is your answer to turning plans into proactive action for RAC success. Authors Elizabeth E. Lamkin, MHA, and Amanda W. Berglund, MS, MBA, describe how to establish and sustain an effective RAC-preparedness structure that can be adapted to fit any organization's system. They provide best practices for successful processes and outline each staff member's role in your RAC audit program. Whether you are responding to a Recovery Auditor or another government auditor, your program must operate as effectively as possible. You will use their tested, proven, and practical tools that will help you build a more effective billing compliance program. You'll learn how to bring finance, business office and clinical staff together for operational improvements that directly affect your bottom line. The RAC Toolkit for Hospitals and Health Systems will help you get the job done right. The RAC Toolkit for Hospitals and Health Systems will help you achieve the following goals: Take a systemic approach to RAC compliance Incorporate effective structure and processes to existing systems for measurable results Organize committees and facilitate information flow Appeal effectively and within deadlines Use proven tools and methods for an effective RAC program Table of Contents: Chapter 1: RAC Program Overview Chapter 2: Preparing for RAC Chapter 3: The Right Structure: Organizing the Committees Chapter 4: The Right People: Three Critical Roles for RAC Prevention Chapter 5: Additional RAC Stakeholders Chapter 6: Automated Reviews Chapter 7: Complex Review and Extrapolation Chapter 8 The Appeal Appendix (Acronyms and additional resources) Take advantage of these valuable tools included in your book: RAC appeal timeline RAC preparedness checklist RAC committee structure flowchart Organizational chart for RAC-related personnel Sample RAC committee meeting agenda Sample UR committee meeting agenda Complex case review worksheet Admission review continued stay and discharge review flowchart Patient status change letter template Automated review timeline Complex review timeline Appeal letter template for appeal level 1 redetermination CMS form 20027 CMS form 20034 CMS form DAB101
THE DRG EXPERT has been a trusted and comprehensive reference to the DRG classification system for over 25 years. Organized by major diagnostic category (MDC), the convenient and innovative book layout follows the logical MS-DRG decision process. This is a must-have reference for those who need to verify DRG information and accurately assign MS-DRGs concurrently or retrospectively.