Outpatient CDI Pocket Guide®: Focusing on HCCs

Pinson & Tang

$165.00

The definitive reference guide for outpatient CDI, the Outpatient CDI Pocket Guide®: Focusing on HCCs features an easy to understand approach, boiling HCCs down to a few basic principles and provides the key references to have ‘at your fingertips’ when working to ensure accurate, complete, and defensible documentation in the outpatient setting.

Offered in the classic spiral-bound format sized to literally “fit in your pocket.”

CEUs:  N/A    N/A AHIMA    N/A AAPC
Price per person. Group rates available.

The definitive reference guide for outpatient CDI, the Outpatient CDI Pocket Guide®: Focusing on HCCs features an easy to understand approach, boiling HCCs down to a few basic principles and provides the key references to have ‘at your fingertips’ when working to ensure accurate, complete, and defensible documentation in the outpatient setting.

Authors Richard Pinson and Cynthia Tang explain how HCCs affect both providers and payers and clarify the chief considerations in outpatient reimbursement, documentation, and coding guidelines. Outpatient CDI Pocket Guide: Focusing on HCCs is appropriate for Clinical Documentation Integrity specialists, coders, risk adjustment auditors, nurses, or physicians.

Outpatient CDI Pocket Guide: Focusing on HCCs is your reference guide to steer you to documentation success for outpatient CDI and HCCs.

  • Focus on areas of greatest impact as you expand your CDI program to the outpatient setting
  • Improve capture of HCC diagnoses that will optimize hospital and physician risk adjustments for value-based payments
  • Increase risk adjustment factor scores for Medicare Advantage health plans
  • Ensure your organization’s outpatient coding practices are compliant and meet clinical validation and documentation requirements.

CDI Pocket Guides are sent via USPS Priority mail.  Allow 2-3 days for delivery. Price includes shipping. 

Special pricing available for groups. Train your entire team!

How Many In Your Group? Group Discount %
1 Retail Price
2-4 5% Discount
5-20 10% Discount
21-100 20% Discount
101+ Contact Us
for Your Custom Price Quote:
[email protected]

Contents: Outpatient CDI Pocket Guide: focusing on HCCs

OUTPATIENT CDI
OUTPATIENT VS. INPATIENT PAYMENT METHODOLOGIES

  • Hospital outpatient payment
  • Physician payment

HCCS AND RISK ADJUSTMENT

  • Medicare vs. Medicare Advantage
  • Who uses HCCs, and How?
  • HCC Methodology
  • CMS-HCC Payment
  • Methodology for MA Plans
    • Hierarchies
    • Disease interactions
  • Diagnosis Sources
  • HCC impact on MA Plans
  • HCC impact on Providers
  • CMS-HCC vs. HHS-HCC

CMS PAY FOR PERFORMANCE PROGRAMS

  • Hospital Pay for Performance Programs
    • Hospital Value-Based Purchasing
    • Hospital Readmissions Reduction (HRRP)
    • Hospital-Acquired Condition Reduction (HACRP)
  • Physician Pay for Performance Programs
    • Accountable Care Organizations (ACO)
    • Merit-Based Incentive Payment System (MIPS)

EXPANDING YOUR CDI PROGRAM

  • HCCs in the inpatient setting
  • Payer denials and appeals
  • Physician office practice
  • Emergency department
  • Observation services

GUIDELINES
OUTPATIENT DIAGNOSTIC CODING GUIDELINES
COMPLICATIONS OF CARE
OUTPATIENT DOCUMENTATION REQUIREMENTS
PHYSICIAN QUERIES
EVALUATION & MANAGEMENT (E/M) GUIDELINES

  • New E/M Payment Rules for 2021

REGULATORY COMPLIANCE

KEY DIAGNOSES
AMPUTATION STATUS
ANGINA
AORTIC ATHEROSCLEROSIS, ANEURYSM, ECTASIA
ARTIFICIAL OPENINGS
CARDIAC DYSRHYTHMIA
CHRONIC KIDNEY DISEASE
COPD/BRONCHITIS/ASTHMA
DEEP VEIN THROMBOSIS
DEMENTIA
DEPRESSION AND BIPOLAR DISORDER
DIABETES MELLITUS
DIABETIC COMPLICATIONS

  • Arthropathy
  • Circulatory disease
  • Hyperglycemia
  • Hypoglycemia
  • Hyperlipidemia
  • Nephropathy
  • Neuropathy
  • Opthalmic
  • Oral complications
  • Osteomyelitis
  • Skin complications

HEART FAILURE
HEPATITIS
HIV/AIDS
MALNUTRITION
NEOPLASMS
OBESITY AND BMI
PARALYSIS (PLEGIA AND PARESIS)
PNEUMONIA
PULMONARY HYPERTENSION & HEART DISEASE
RESPIRATORY FAILURE
SKIN ULCERS
SUBSTANCE USE, ABUSE, DEPENDENCE
PROVIDER HCC FAVORITES LIST

HCCS
OVERVIEW
CMS-HCCS, V24.0
HCC COMMON DIAGNOSIS LIST
COMMON DIAGNOSIS LIST BY HCC

Dr. Richard Pinson, MD, FACP, CCS
Dr. Richard Pinson is a physician, educator, administrator, and healthcare consultant. He practiced Internal Medicine and Emergency Medicine in Tennessee for over 20 years having board certification in both. Dr. Pinson is a Fellow of the American College of Physicians and former Assistant Professor of Clinical Medicine at Vanderbilt, and has assisted hospitals as a physician consultant for the past ten years.

His personal understanding of the mindset of both doctors and managers allows him a unique vantage point from which to promote cooperation between physicians, hospital staff, and administrators toward achieving beneficial and practical changes.

 

Cynthia Tang, RHIA, CCS
Cynthia brings over 30 years of experience in health information management, coding and clinical documentation, and clinical resource management. For the past twenty years she has traveled to hospitals throughout the country to assess their processes for managing health information and clinical documentation and to provide her much-sought after expertise in redesigning operations to promote better patient care and hospital financial health.

Her focus is on workflow design and improving clinical documentation with a view to optimizing reimbursement, ensuring compliance, and improving quality and pay for performance measures.

 

Reviews

There are no reviews yet.

Be the first to review “Outpatient CDI Pocket Guide®: Focusing on HCCs”

Your email address will not be published. Required fields are marked *

You might also find this helpful…

  • CEUs

    CDI Essential Skills

    $295.00

    Developed by ACDIS, the premier provider of education for Clinical Documentation Improvement Professionals, CDI Essential Skills is a certificate program comprised of foundational CDI education paired with a review of core compliance and ethical principles. Candidates who pass the final exam receive a certificate of completion and may designate themselves as an ACDIS-Approved CDI Apprentice.

    CDI Essential Skills includes:

    • Introduction to CDI: Core Concepts and Professional Skills
    • Understanding the DRG and IPPS Systems
    • Coding Essentials for the CDI Specialist
    • Conducting the Health Record Review
    • Introduction to Queries and the Query Process
    • Documentation Requirements for Sepsis
    • Documentation Requirements for CHF
    • Documentation Requirements for Respiratory Failure
    • Documentation Requirements for Malnutrition
    • ACDIS CDI Apprenticeship

    CDI Essential Skills is a first step to a career in Clinical Documentation Improvement.  This online training has been designed as a pathway to future Certified Clinical Documentation Specialist (CCDS) designation. Candidates interested in obtaining the CCDS credential must fulfill prerequisites, including at least two years of experience in clinical documentation improvement.

    Libman Education is an authorized reseller of CDI Essential Skills.

  • Hospital Coding

    CDI Pocket Guide®

    $99.00$179.00

    Keep vital information at your fingertips with the 2022 edition of the #1 best-selling authoritative CDI Pocket Guide®.

    The CDI Pocket Guide® by authors Dr. Richard Pinson and Cynthia Tang, now in its 15th edition, is the original and STILL the best resource for coding and clinical documentation integrity.

    Each year, the authors research, revise, and clarify the content to update the original CDI Pocket Guide®. They capture significant changes in clinical diagnostic standards, ICD-10 codes, Official Coding Guidelines, Coding Clinic, and compliance issues and accommodate useful feedback from readers. They also provide the wisdom of their experience as consultants helping hospitals sculpt their documentation and coding practices to their needs.

    Each CDI Pocket Guide® customer will also have access to Free Monthly Webinars.

    For 15 years, the CDI Pocket Guide® has been the essential, go-to resource for anyone involved in coding and CDI – don’t be without it!

    The 2022 CDI Pocket Guide® gives you access the latest CDI updates including:

    • Fiscal Year and Final Rule changes
    • Quarterly Coding Clinic advice
    • Mid-year COVID-19 guidelines
    • Newly added conditions, diagnostic criteria updates and guidance
    • And much more content and features…

    CDI Pocket Guide for 2022 to ship mid-October. CDI Pocket Guides are sent via USPS Priority mail. Allow 2-3 days for delivery. Price includes shipping. 

  • ICD-10-PCS, ICD-10-CM

    Coding Clinic Commentaries

    $25.00$100.00

    In-depth commentary on selected coding advice and clarifications from recent issues of AHA Coding Clinic for ICD-10-CM and ICD-10-PCS, the official publication for ICD-10-CM and ICD-10-PCS coding guidelines and advice.

    Purchase a full year and receive the current issue plus the next three issues. In addition, receive access to the full Coding Clinic Commentary archives to see what you may have missed. The four most recent issues of Coding Clinic Commentary offer Prior Approval CEUs that are valid for one year after issue.

    • What changed, what it means, and how to apply advice with confidence
    • Coding Clinic advice will be explored and explained in the context of the conventions and guidelines that govern how ICD-10-CM and ICD-10-PCS codes are applied
    • Online commentary provides unlimited access to materials for entire enrollment period
    • Learn from an experienced presenter on Coding Clinic issues, known for in depth knowledge and an ability to put coding questions into an understandable context
    • Requires access to AHA Coding Clinic for ICD-10-CM and ICD-10-PCS. Subscribe here.

    Libman Education’s Coding Clinic commentaries are included at no charge in the eLearning Library subscriptions.

  • Learning Aids ICD-10-CM

    HCC Quick Reference Guide

    $59.00

    The HCC Quick Reference Guide is a useful tool to communicate quickly and clearly to your providers the essential documentation necessary to support HCC diagnoses. Delivered as a downloadable and printable .pdf, the HCC Quick Reference Guide features straight-forward instruction for providers in 15 specialties.

    The HCC Quick Reference Guide includes the diagnostic statements that must be documented to support correct coding of the HCC. There are no ICD-10-CM codes in the course; just guidance on what to document.

    Designed to be shared with your providers, the HCC Quick Reference Guide is a unique product, organized by specialty to make the guidance more user-friendly and the information more accessible. The HCC Quick Reference Guide is ideal for Clinical Documentation Integrity specialists, any coder who provides HCC documentation guidance to providers, or any provider who wants succinct guidance on mastering HCCs.

    The HCC Quick Reference Guide provides a concise set of information for each specialty:

    • Cardiovascular
    • Dermatology
    • Endocrinology
    • Gastroenterology
    • Hematology
    • Internal Medicine – Family Practice
    • Mental Health and Substance Abuse
    • Nephrology and Urology
    • Neurology
    • Oncology
    • Ophthalmology
    • Orthopedics
    • Pulmonology
    • Rheumatology
    • Trauma

    Each guide provides the key information needed for accurate HCC documentation of diagnoses in that specialty:

    • HCC hierarchy
    • Disease Interaction (Institutional)
    • Disabled/Disease Interaction
    • Alphabetical listing of diagnostic statements

    Plus!  Designed to be shared with your providers, the HCC Quick Reference Guide provides additional instruction in straightforward language on how HCCs work and how it affects the provider’s documentation including:

    • Risk Adjustment Factors (RAF)
    • Coefficients
    • Trumping