Sepsis Coding (Audio Conference)

AUDIOCONFERENCE ON TAPE OR CD

Sponsored by JustCoding.com

presented on March 21, 2007

Sepsis—a severe illness caused by overwhelming infection—is one of the most difficult areas for coders to understand, and with good reason. The terminology used to describe it is confusing and coders can have a hard time reporting the correct code if the documentation is unclear.

Now, with many states requiring present-on-admission (POA) indicators, and ICD-9-CM new rules specifying how septicemia is sequenced, there has to be clinical recognition of sepsis—with documentation—on admission. Coders need to understand sepsis from a clinical point of view and be prepared to query physicians for the details needed to properly report sepsis. Failing to do so can dramatically affect final DRG assignment, reimbursement, and compliance.

Listen to HCPro's audioconference and learn how to manage sepsis coding challenges. Our speakers will discuss terminology, use case studies to demonstrate appropriate coding and sequencing, and give you resources and strategies to improve your understanding and coding accuracy.

NOTE: This is an intermediate- to advanced-level program. While a beginner should be able to grasp the concepts of this program, the speakers strongly recommend that participants review the following references prior to the program to gain the most benefit from it:

• The most current set of ICD-9-CM guidelines (http://www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdguide06.pdf)
• Sepsis terminology and definitions, available from your facility’s medical librarian.

TAKE A LOOK AT OUR AGENDA

1. Sepsis terminology including infection, urosepsis, bacteremia, septicemia, sepsis, severe sepsis, and their associated organ failures
1. Definitions from Coding Clinic
2. ICD-9-CM rules
3. Finding the supportive clinical information within the record
2. Coding and sequencing: Selecting codes for a variety of sepsis documentation—with case studies
3. DRG issues
1. Changes for 2007 and the new DRGs such as for sepsis with ventilator
2. Changes in surgery, e.g., excisional debridement—with or without sepsis
4. Compliance strategies and indicators to support querying the physician

LEARNING OBJECTIVES

At the end of the audioconference, you will be able to:

• Identify the clinical aspects and definitions of the most confusing terms:  Infection, urosepsis, bacteremia, septicemia, sepsis, severe sepsis, and their associated organ failures
• Explain the 2007 ICD-9-CM coding guidelines, including sequencing rules, that are pertinent to sepsis
• Demonstrate the POA flags and indicators and use administrative data to apply the principles to DRG/case mix management and quality assessment
• Analyze the compliance concerns surrounding sepsis and implement proactive measures to protect your facility, including suggestions on how and when to query physicians

FEATURED SPEAKERS

James S. Kennedy, MD, CCS, is senior physician executive in the FTI Cambio Health Solutions group of FTI's Corporate Finance practice and is based in Brentwood, TN. His expertise includes physician and hospital leadership, healthcare systems improvement, healthcare documentation and coding compliance, and government relations. He regularly educates physicians and hospital staffs on these topics, promoting physician data quality, the facilitation of outcomes measurement and physician re-credentialing, reductions in payment denials, and averting legal and compliance issues for healthcare entities.

Cindy Basham, MHA, RN, CPC, CCS, is a senior regulatory specialist with HCPro, Inc. and serves as an instructor for both the Certified Coder Boot Camp®--Original Version (covers physician and outpatient hospital coding) and the Certified Coder Boot Camp®--Inpatient Version (covers hospital inpatient facility services). As a member of HCPro, Inc.'s consulting staff, she works with hospitals, medical practices, and other healthcare providers on a wide range of coding and documentation-related issues with a particular focus on coding, billing, and compliance reviews/audits.

BONUS MATERIAL INCLUDED IN YOUR MATERIAL PACKET!

In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials and tools, as well as the following:

• Links to useful resources such as international sepsis articles, hospital payment monitoring program/QIO tools, and ICD-9-CM rules and regulations
• Sample physician query form for sepsis

These materials are provided with PDF links.

WHO SHOULD LISTEN?

HIM directors, managers, and staff; coding supervisors; billing managers; case managers; compliance managers; physician executives and advisors to case management or HIM; quality improvement/core measures directors and managers; critical care managers, including in the ED

Purchase a tape or CD of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.

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