The Physician Advisor s Guide to Clinical Documentation Improvement

Physician advisors are not just needed for case management anymore. ICD-10-CM/PCS and the changing landscape of healthcare reimbursement make their input invaluable in the realm of CDI and coding, too. This book will help your physician advisors quickly understand the vital role they play and how they can not only help improve healthcare reimbursement, but also reduce claims denials and improve the quality of care overall.

This book will:

- Provide job descriptions and sample roles and responsibilities for CDI physician advisors
- Outline the importance of CDI efforts in specific relation to the needs and expectations of physicians
- Highlight documentation improvement focus areas by Major Diagnostic Category
- Review government initiatives and claims denial patterns, providing physician advisors concrete tools to sway physician documentation

Table of Contents

- CDI Foundation
- Risk and severity adjustments
- Payment models
- Coding foundations
- Query compliance
- Clinical conditions
- Regulatory oversight/auditors
- CDI program monitoring