Successfully Appealing Clinical Validation and Coding Issues in AKI, ATN and Pneumonia

Acute Kidney Injury (AKI) and Acute Tubular Necrosis (ATN) remain a target for both clinical and coding validation. Why is that? We will discuss current coding guidelines and clinical indicators for AKI/ATN. We will discuss why coding and clinical denials for AKI/ATN 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 pneumonia denials.

Join us as we share what we’ve learned over the years from appealing hundreds of coding and clinical validation denials for AKI/ATN and pneumonia 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 AKI/ATN and pneumonia.
  • Discover successful strategies to compose winning appeals when the AKI/ATN or pneumonia diagnosis is denied, even though you got it right.