Malnutrition remains a target for both clinical and coding validation. Why is that? We will discuss current coding guidelines and clinical indicators for malnutrition. We will discuss why coding and clinical denials for malnutrition are different and why different appeal strategies are necessary. And, as a special “twofer”, we’ll also present coding and clinical validation considerations and appeal strategies for congestive heart failure denials.
Join us as we share what we’ve learned over the years from appealing hundreds of coding and clinical validation denials for malnutrition and congestive heart failure on behalf of our hospital clients. We’ll reveal payer behaviors regarding auditing and denying these diagnosis codes. And, as always, we will share proven, successful appeal strategies that you can use right away.
Learning Objectives:
- Understand common denial rationale.
- Recognize the differences between coding and clinical denials for malnutrition and congestive heart failure.
- Discover successful strategies to compose winning appeals when the malnutrition and congestive heart failure diagnosis is denied, even though you got it right.
