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Displaying records 1 to 20 out of 5386 results for "Anesthesia Documentation Requirements".
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SORT RESULTS BY: RELEVANCY | PUBLICATION DATE
Fill in the blank: The Joint Commission standards that cover sedation and anesthesia apply to all
Here are some of the highlights from the document/covid-recomm
AUGUST 27, 2020
Anesthesia providers have low hand hygiene compliance rates, according to a new study by research
MARCH 4, 2015
JUSTCODING
ACGME-accredited programs are required to establish clinical competency committees (CCC) to evalu
JULY 12, 2018
Make a list of all areas that are required to have positive or negative air pressure and ensure t
JUNE 1, 2018
Make a list of all areas that are required to have positive or negative air pressure and ensure
JULY 1, 2018
Make a list of all areas that are required to have positive or negative air pressure and ensure t
MAY 1, 2018
It has been seven years since The Joint Commission announced its OPPE and FPPE requirements, and
CMS doesn't require Medicare Advantage plans to have a face-to-face document for home health. Bu
Can the plan of care serve as a way to document medications?  
  A recent study published in the Canadian Journal of Anesthesia found that medica
APRIL 10, 2015
Documentation of terminal illness at admission and during the hospice service period must be deta
Documentation of terminal illness at admission and during the hospice service period must be det
When officials at a California hospital suspected that someone was stealing drugs from anesthesia
MAY 12, 2016
To accurately interpret and code physician documentation, the HIM department should employ
JUNE 4, 2014
JUSTCODING
Residents are a little-utilized but critical link in the documentation chain that drives hospital
JULY 7, 2017
Now in its second edition, documentation-improv
APRIL 9, 2014
JUSTCODING
Now in its second edition, documentation-improv
JUNE 4, 2014
JUSTCODING
Now in its second edition, documentation-improv
AUGUST 13, 2014
JUSTCODING
An outpatient clinical documentation improvement (CDI) program should be aligned with a fa
by Penny Richards ACDIS announces several changes in eligibility requirements for
In December 2014, CMS posted a document on its Advisory Panel on Hospital Outpatient Payme
Residents are a little-utilized but critical link in the documentation chain that drives
JULY 14, 2017
Become more proactive. You no longer can wait for face-to-face documentation to arrive within sev
  A Comprehensive Error Rate Testing (CERT) study found insufficient documentation
JULY 22, 2015
JUSTCODING
There has been a fair amount of coverage on the documentation requirements needed to assign ICD-1
The focus for clinical documentation improvement (CDI) specialists has historically been on the i
FEBRUARY 21, 2017
Months after NAHC had sued Medicare regarding the face-to-face requirement under the Affordable
CMS has reversed its stance requiring Medicare Advantage (MA) plans to apply Medicare fee-for-ser
Documentation Documentation
The Association of Clinical Documentation Improvement Specialists (ACDIS), the nation’s onl
JANUARY 19, 2016
Is it true that the following documentation is an improper certification statement on our
  Why are physician queries so critical to accurate documentation and coding? The an
We all know that ICD-10 codes will require more complete documentation. We’ve been t
Q&A: Managing LS, EC, and EM documentation Editor
DECEMBER 20, 2016
With the transition to ICD-10, some documentation issues have required the capture of new inform
With the transition to ICD-10, some documentation issues have required the capture of new informa
In a recent frequently asked questions (FAQ) document released by the Centers for Medicare &
The ANCC Magnet Recognition Program® (MRP) requires hospitals to have evidence-based practice
MARCH 6, 2015
Research presented at the International Anesthesia Research Society (IARS) Annual Meeting th
MARCH 25, 2015
The Association of Clinical Documentation Improvement Specialists (ACDIS), the premier healthcar
SEPTEMBER 10, 2012
The Certified Clinical Documentation Specialist (CCDS) exam hit a pretty big milestone last weeke
by Kirsten Dize Make completing documentation in the home a requirement for all
Take a close look at the documentation guidelines that CMS suggests for the practice improvement
The Joint Commission (TJC) includes a requirement under the Provision of Care, Treatment and Service
ICD-10-CM simplifies coding for sepsis provided the physician completely and accurately documents
NOVEMBER 18, 2015
JUSTCODING
This fact sheet outlines specific compliance requirements for Hospice Item Set (HIS) and Consumer
Have you thought about the changes to RAPs and the new Notice of Admission requirement fi
Insufficient documentation led to approximately 97% of improper payments for kyphoplasty a
JULY 23, 2014
JUSTCODING
Citing feedback that required further research, The Joint Commission last week announced it will
"[A]s we enter into clinical practice, physicians face the burdens of documentation and reg
SEPTEMBER 17, 2015
Q: Can you tell me whether there is a resource that lists documents and required retentio
This summer, the ACGME approved revisions to Sections I–V of the Common Program Requirement
OCTOBER 18, 2018
Although CMS has issued blanket waivers, the vast majority of the Medicare requirements remain in
I have a question regarding the face-to-face requirements for homecare. It is my understa
There’s more specific requirements for the governing body—for example, the QAPI progr
No. The regulations do not mandate any particular form or format for documentation or confirmati
The Joint Commission has postponed the implementation of revised diagnostic imaging requirements
  Documentation standards
JANUARY 1, 2015
Procedures are detailed descriptions of the tasks required to implement and maintain agency polic
I am searching for clear, legitimate, documented guidance regarding coding for a verbal o
A CMS requires that a physician narrative be included in a patient’s hospice recert
CMS added three new questions on meaningful use requirements to their FAQ website. The new FAQs c
NOVEMBER 17, 2015
New EP: Avoid RFIs by keeping documents and service manuals in library “If it was
JANUARY 1, 2018
In recent years, hospitals have increasingly focused on creating clinical documentation improveme
New EP: Avoid RFIs by keeping documents and service manuals in library “If it was
DECEMBER 1, 2017
Documentation: Getting the details right Joint Commission eli
DECEMBER 6, 2016
If you feel pretty confident as an agency that your documentation can pass muster and the totalit
Documentation will be important to support supply utilization and payment. Claims
CMS requires that a physician narrative be included in a patient’s hospice recertification
OCTOBER 8, 2014
JUSTCODING
I understand CMS now has a requirement that physicians must estimate the number of visits
In order to be compliant with The Joint Commission’s requirements of establishing and trac
JUNE 18, 2015
Click the PDF icon above to download. Included in this document:
Correct, complete documentation is the foundation of a sound medical record and compliant reimbur
JUNE 15, 2018
Q: In regard to clients requiring 30-day reassessments for therapy, if a client has the init
  Documentation terminology that will not support the Medicare claim
A patient comes into the ED following an automobile accident. The physician documents that the pa
CMS announced proposed changes to the Medicare long-term care requirements that would reform &ldq
SEPTEMBER 6, 2019
Non-enforcement of supervision requirements for certain therapeutic services for critical
Generally, for Medicaid Advantage, the documentation is that the face-to-face date needs to be on
A newly proposed rule by CMS would put into effect new discharge planning requirements that the a
SEPTEMBER 26, 2019
Q: It is my understanding that written authorization is required for the release of PHI even f
Many questions have swirled around the issue of medical necessity and how to document it appropri
DECEMBER 1, 2015
The patient care plan (485) is not a stand-alone documentation system; it is the legal record of
Regardless of the clinical background of those responsible for reviewing documentation, it can be
Even before ICD-10-CM was delayed until October 1, 2015, the quality of physician document
SEPTEMBER 3, 2014
JUSTCODING
SEPTEMBER 3, 2014
JUSTCODING
It’s an age-old question: How do you get physicians to support documentation improvement ef
by: Josh Poltilove Conduct a quality audit of documentation your therapists submi
By James S. Kennedy, MD, CCS, CDIP The physician documented “encephalopathy&
MARCH 25, 2015
JUSTCODING
Annual home health in-service training is not only required to remain compliant with CMS and stat
Sponsored by MasterLock Lockout and tagout are often considered requir
NOVEMBER 28, 2018
Coding guidelines direct to code all documented conditions that exist at the time of the visit an
HCPro, Inc. and the Association of Clinical Documentation Improvem
The proof of medical necessity strictly relies on the MD documentation and diagnosis and the skil
  Q&A: Documentation for body mass index
  Skilled Services: How to document for proper reimbursement
OCTOBER 9, 2015
  A tool for your CNAs to help with accurate ADL documentation
  CMS issues guidance for handling insufficient documentation, ADRs
  Key documentation criteria for supporting the Medicare claim
SEPTEMBER 21, 2018
  Featured member resource: ADR appeal documentation checklist
NOVEMBER 16, 2018
The Association of Clinical Documentation Improvement Sp
OCTOBER 1, 2010
by: Kirsten Dize CMS’ revised OASIS Q&A document offers welcome insight
Documenting medical necessity has become a big topic over the last several years and there has be
MARCH 22, 2019
ACDIS is proud to celebrate the 3,000th Certified Clinical Documentation Specialist (CCDS) creden
Although the rules for selecting QAPI data are flexible, CMS does require that programs document
A patient presents to the ED with a headache, nausea, and vomiting. The physician documented that
FEBRUARY 25, 2015
JUSTCODING
Take advantage of supplies that require fewer visits. For example, use of silver dressings or a h
Editor’s note: With the increased specificity required for ICD-10-CM coding, code
AUGUST 20, 2014
JUSTCODING
MAY 6, 2015
JUSTCODING
A proposed CMS change to the 2017 Medicare Physician Fee Schedule will require surgeons document
SEPTEMBER 13, 2016
 As part of the first day’s review of documents, be prepared to show surveyors the res
SEPTEMBER 1, 2018
As part of the first day’s review of documents, be prepared to show surveyors the results o
SEPTEMBER 1, 2018
It has been a little over six weeks since the implementation of the new reporting requirements fo
FEBRUARY 11, 2015
JUSTCODING
In addition to documentation by physicians, nurses’ documentation affects patient safety,
JANUARY 8, 2020
Moving on to the rest of the guidance document (it still
FEBRUARY 28, 2019
Bylaws serve as the governing documents of the medical staff. Bylaws must meet the hospital&rsquo
DECEMBER 13, 2013
APRIL 23, 2014
JUSTCODING
JULY 9, 2014
JUSTCODING
JULY 16, 2014
JUSTCODING
JULY 23, 2014
JUSTCODING
JULY 30, 2014
JUSTCODING
Establishing a frequency is considered very unique, as a psychiatric patient sometimes requires t
ACDIS is making several changes to the Certified Clinical Documentation Specialist exam effective
As of last week, 2,910 people hold the Certified Clinical Documentation Specialist credentia
You note that under the revised Home Health CoPs, agencies already are required to have an indivi
  When a provider fails to document whether a patient diagnosed with monoplegia ha
MAY 13, 2015
JUSTCODING
MARCH 5, 2014
JUSTCODING
by Tami Swartz Thoroughly examine clinicians’ documentation &mdash
What documentation is necessary for a medication review? The regulation
Coder training, physician documentation, and new technology integration rank among the top concer
Coding for sepsis requires a strong knowledge of ICD-9-CM coding guidelines, as well as complete
DECEMBER 17, 2014
JUSTCODING
Implementing a hazardous waste management program requires five primary steps Inspector
 Documentation
Using a streamlined approach to EHR documentation may help reduce stress for resident, according
AUGUST 7, 2015
Insurer-provider discord mounts over new HIPPS code requirement
NOVEMBER 1, 2014
We want physicians to be very clear in their documentation about what’s wrong with the pati
JUNE 10, 2015
JUSTCODING
CMS posted updated versions of all the guidance documents posted on the
MARCH 26, 2014
JUSTCODING
Section V of the revised Common Program Requirements that went into effect in July features new l
NOVEMBER 12, 2019
Both a medical necessity and a compliance requirement Involving patients in their care
FEBRUARY 1, 2018
Editor's note: With the increased specificity required for ICD-10-CM coding, coders nee
OCTOBER 29, 2014
JUSTCODING
Effective documentation of the condition and the patients’ co-morbidities may help lawyers
Incomplete documentation in patient clinical records can cause your organization legal and settle
SEPTEMBER 18, 2019
Editor’s note: With the increased specificity required for ICD-10-CM coding, code
AUGUST 6, 2014
JUSTCODING
Physicians who provide E/M services must document the necessary clinical information to support t
  More oversight is required to prevent fraud and abuse of Medicare
  New Medicare Compliance and Ethics Program Requirements
  SNFs Seek Relief from Three-Day Hospital Stay Requirement
NOVEMBER 3, 2017
  Understanding phase 2 requirements for survey readiness
FEBRUARY 23, 2018
  Providers encouraged to review eligibility requirements for expanded dispute resolution proce
  Three new regulatory requirements that implicate service contracts
  Q&A: Reducing readmissions to meet SNF VBP requirements
DECEMBER 21, 2018
  Special requirements for billing urology supplies & updated DMEPOS fee schedule
DECEMBER 21, 2018
I was recently fielding a question about the required frequencies for hazard surveillance rounds
AUGUST 16, 2018
Medical staffs across the country are discovering their governance documents are inadequate for t
Wisconsin Governor Scott Walker signed document/acts/201
Professionalism, accountability, and ethics are increasingly required for success in home health.
Professionalism, accountability, and ethics are increasingly required for success in home
Professionalism, accountability, and ethics are increasingly required for success in home health.
Professionalism, accountability, and ethics are increasingly required for success in home health.
NOVEMBER 4, 2015
JUSTCODING
Doing it right the first time requires an investment of time, energy, and resources. But it&rsqu
Copyright statement
SEPTEMBER 4, 2008
Emergencies that introduce contamination into a hospital require a special type of planni
FEBRUARY 2, 2017
 Although documentation matters more and more in today?s world of ever-changing regulations, med
AUGUST 4, 2017
Agencies need to begin now to ensure that they are getting valid face-to-face documentation with the
Terms of use synopsis
SEPTEMBER 4, 2008
Q: I’m in a little debate: Does documentation of the patient’s body mass in
MAY 7, 2014
JUSTCODING
Q: Can you code strictly from emergency room (ER) documentation? Can you code from test re
Supreme Court decision narrows the requirements for physician
by Josh Poltilove To help comply with the new patient rights requirement
ACDIS, the Association of Clinical Documentation Impro
APRIL 7, 2011
OSHA has released twin bulletins requiring staffing agencies and host employers to share responsi
OSHA has released twin bulletins requiring staffing agencies and host employers to share responsi
JANUARY 1, 2019
The ACGME Common Program Requirements Phase 2 Task Force recently released proposed major revisio
FEBRUARY 9, 2018
Documentation Two strategies for holding physicians accountable
  CMS releases coverage criteria for TAVR volume requirements 
By Cheryl Ericson, MS, RN, CCDS, CDIP Many clinical documentation improvement (CDI
JULY 29, 2015
JUSTCODING
Providers don’t often receive education on clinical documentation, which can be a challenge
These Occupational Health and Safety Forms provide you with all of the updates for your OSHA Health and Safety Compliance Manual.
DECEMBER 17, 2008
Q: Can you code strictly from emergency department (ED) documentation? Can you code from tes
DECEMBER 16, 2015
JUSTCODING
Correct, complete documentation is the foundation of a sound medical record and compliant reimbu
JUNE 15, 2018
  Editor’s note: With the increased specificity required for ICD-10-CM co
DECEMBER 23, 2014
JUSTCODING
APRIL 2, 2014
JUSTCODING
Q: My question is about the time interval requirement of the CPT® add-on
APRIL 2, 2014
JUSTCODING
NCCI guidelines for Part B Billing New coding requirements r
  Antibiotic stewardship addressed head on in CMS’ revised infection control requirements
  CMS call to clarify qualified Medicare beneficiary (QMB) program billing requirements
  SNFs found to be out of compliance with QRP requirements will receive letter from CMS
  CMS makes several Medicaid announcements, including new audits and requirement for budget neu
AUGUST 24, 2018
Proper documentation is critical when it comes to supporting medical necessity and providing qual
Q: What are some tips when evaluating our documentation system?
What should our clinicians document if the patient hasn't had the flu vaccine yet? The pa
Recently the ACGME Board of Directors approved major revisions to Common Program Requirements Se
JULY 27, 2018
  Editor’s note: With the increased specificity required for ICD-10-CM co
JULY 23, 2014
JUSTCODING
  Medical staffs are discovering their governance documents are inadequate for tod
SEPTEMBER 18, 2014
FEBRUARY 12, 2014
JUSTCODING
SEPTEMBER 24, 2014
JUSTCODING
AUGUST 26, 2015
JUSTCODING
CMS revises signature requirements On July 24, CMS released a change re