Yes The RAC in our area ( Cotviti) is using sepsis 3 criteria to clinically validate sepsis.
They are only allowed to do this by CMS with Medicare advantage patients and not traditional Medicare where the code validation is not clinically validated. However with the next contract cycle it is likely that they will validate clinically all Medicare patients. Stay tuned ! William E. Haik, M.D., F.C.C.P., C.D.I.P. AHIMA Approved ICD-10-CM/PCS Trainer Office: (850) 863-2110 Cell: (850) 803-5854 Fax: (850) 864-4438 > On Oct 12, 2017, at 3:08 PM, [email protected] > wrote: > > Send Sepsisgroups mailing list submissions to > [email protected] > > To subscribe or unsubscribe via the World Wide Web, visit > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > or, via email, send a message with subject or body 'help' to > [email protected] > > You can reach the person managing the list at > [email protected] > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Claims denials using SEP-1 vs. Sepsis-3 definitions of sepsis > (Amanda Sigala) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Tue, 10 Oct 2017 12:43:03 -0700 > From: "Amanda Sigala" <[email protected]> > To: <[email protected]> > Subject: [Sepsis Groups] Claims denials using SEP-1 vs. Sepsis-3 > definitions of sepsis > Message-ID: <[email protected]> > Content-Type: text/plain; charset="us-ascii" > > Has anyone experienced denials from payers based on provider documentation > using SEP-1 vs. Sepsis-3 definitions of sepsis? If so, what changes did you > make to your documentation/coding/billing? > > > > Thank you, > > Amanda > > > > Amanda Sigala RN, BSN, MPH > > Clinical Quality Specialist > > Quality Improvement > > Harborview Medical Center > > Box 359731 > 325 Ninth Avenue > > Seattle, WA 98104 > > Phone: 206-744-9433 > > <mailto:[email protected]> [email protected] > > > > <http://uwmedicine.org/> Description: Visit UW Medicine on.line > > > > This message and any attachments to it is protected by coordinated quality > improvement/risk management/peer review confidentiality under RCW > 70.41.200/4.24.250/43.70.510. Privileged confidential patient identifiable > information also may be contained in this message. This information is > meant only for the use of the intended recipients. If you are not the > intended recipient or if the message has been addressed to you in error, do > not read, disclose, reproduce, distribute, disseminate or otherwise use this > transmission. Instead, please notify the sender by reply email and then > destroy all copies of the message and any attachments. > > > > The above email may contain patient identifiable or confidential > information. Because email is not secure, please be aware of associated > risks of email transmission. If you are a patient, communicating to a UW > Medicine Provider via email implies your agreement to email communication; > see <http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm> > http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm > > > The information is intended for the individual named above. If you are not > the intended recipient, any disclosure, copying, distribution or use of the > contents of this information is prohibited. Please notify the sender by > reply email, and then destroy all copies of the message and any attachments. > See our Notice of Privacy Practices at <http://www.uwmedicine.org/> > www.uwmedicine.org > > > > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20171010/49ce7a65/attachment-0001.html> > -------------- next part -------------- > A non-text attachment was scrubbed... > Name: image001.gif > Type: image/gif > Size: 3302 bytes > Desc: not available > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20171010/49ce7a65/attachment-0001.gif> > > ------------------------------ > > Subject: Digest Footer > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > ------------------------------ > > End of Sepsisgroups Digest, Vol 265, Issue 1 > ********************************************
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