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Respiratory Failure is high on the list of RACs and the OIG, due to documentation concerns and the need for clinical indicators and treatment, as is Acute Renal Failure which has been replaced with the new term, Acute Kidney Injury. Congestive Heart Failure is another diagnosis high on the list of RACs and OIG. The Acuity in CHF is important for physicians to document, as it will be reflected through different codes, and can affect DRG’s/reimbursement. This presentation will cover documentation elements needed to establish appropriate severity and DRGs. Applications and scenarios for reporting the new codes, as well as reimbursement potentials, from a Centers for Medicare and Medicaid Services perspective, will be addressed.


Stacy Hardin, RHIT, CCS, AHIMA Approved ICD 10 CM/PCS Trainer
Director of Coding Services for Reimbursement Management Consultants, Inc.


1.0 CEU – Clinical Data Management

Date Published

November 10, 2017