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RE: Question regarding SOAP
Thank you for the quick response. The soap response was big, so I was directing the response to IFS file and then parsing the IFS file. I was using the below api. I was messing with the CCSID to see if I will get the soap response correctly.
HTTP_SetFileCCSID(1208) ;
HTTP_SetCCSIDs( 1208 : 37 : 1208 : 37) ;
soapfilename = http_tempfile() + '.soap' ;
rc = http_url_post(
url
: %addr(SOAP) + 2
: %len(SOAP)
: soapfilename
: HTTP_TIMEOUT
: HTTP_USERAGENT
: 'text/xml; charset=utf-8') ;
Attached is the debug.txt.
Regarding the second question about parsing, I was trying to change < > to < > and see if this will correct the aphostrope and '&'. Was trying to see if http_parse_xml_stmf would parse the data and dump to IFS file. Now I understand that I don't have to do this based on your response. All I have to make sure is that the soap response is received correctly.
XML-INTO was able to parse the soap response correctly up until it encountered the junk for aphostrophe.
Thank you,
Sunil
-----Original Message-----
From: ftpapi-bounces@xxxxxxxxxxxxxxxxxxxxxx [mailto:ftpapi-bounces@xxxxxxxxxxxxxxxxxxxxxx] On Behalf Of Scott Klement
Sent: Thursday, October 29, 2009 12:56 PM
To: HTTPAPI and FTPAPI Projects
Subject: Re: Question regarding SOAP
Hello Sunil,
Sorry, it's not clear to me what you're actually doing. I understand
how you're setting the file CCSID, and how you're setting the POST and
Protocol CCSIDs (why *are* you changing the protocol CCSID!?!)
But you didn't tell me which API you're calling in HTTPAPI. Should I
assume it's http_parse_xml_stmf?
http_parse_xml_stmf() doesn't use the HTTP_setCCSIDs() or
HTTP_setFileCCSID() values. It only uses the CCSID you specify in it's
parameter list. The output CCSID is always your job's CCSID (or default
CCSID).
The HTTP_setCCSIDs() sets only the POST data and Protocol CCSID (and you
really should not be messing with the protocol CCSID!)
The HTTP_setFileCCSID() just tags new file downloads with that CCSID.
It is never used for translation, and if you're not downloading a file,
it doesn't have any effect at all.
You asked "how do I put the output of http_parse_xml_stmf into a file...
I don't understand the question. http_parse_xml_stmf's job is to
*read* a file and put the data into your program's variables. What good
would it do to put the output into a file? It was already in a file to
begin with!
Gonchigar, Sunil wrote:
> Hello Scott,
>
>
>
> I downloaded the httpapi and trying some web service calls. Thank you
> for the wealth of information. I just hope I can convince my peers to
> have this tool on production boxes.
>
>
>
> couple questions
>
> 1. I am getting a soap response into IFS file and the apostrophe(`)
> is getting translated as �EUR(TM)....hex(622039). So as `&' (and)
> with �EUR" hex(622033). The <.....> is translating correctly to
> <>. How do I resolve this? I have used the following
> before using "http_url_post "
>
> HTTP_SetFileCCSID(1208) ;
>
> HTTP_SetCCSIDs( 1208 : 37 : 1208 : 37) ;
>
> 2. How to put the output of "http_parse_xml_stmf" into IFS file.
>
>
>
> Thank you and appreciate your help
>
> Sunil
>
>
>
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HTTPAPI Ver 1.23 released 2008-04-24
OS/400 Ver V5R4M0
File CCSID changed to1208
New iconv() objects set, PostRem=1208. PostLoc=37. ProtRem=1208. ProtLoc=37
http_url_post(): entered
http_persist_open(): entered
http_long_ParseURL(): entered
DNS resolver retrans: 20
DNS resolver retry : 3
DNS resolver options: x'00000136'
DNS default domain: rmf.ps.net
DNS server found: 155.16.80.3
DNS server found: 204.148.236.3
DNS server found: 155.16.44.30
http_persist_post(): entered
http_long_ParseURL(): entered
do_post(): entered
POST /prweb/PRSOAPServlet HTTP/1.1
Host: 155.17.173.131:9086
User-Agent: http-api/1.23
Content-Type: text/xml; charset=utf-8
Expect: 100-continue
Content-Length: 680
Cookie: $Version=0; jsessionid=00008Fbba4EDmdzLUiT3nllXwH_:-1; $Path=/;
SOAPAction: "urn:PegaRULES:SOAP:CARDSReferenceService:Services#CARDSReferenceGateway"
recvresp(): entered
HTTP/1.1 100 Continue
Content-Length: 0
Date: Thu, 29 Oct 2009 04:11:32 GMT
Server: WebSphere Application Server/6.1
SetError() #13: HTTP/1.1 100 Continue
senddoc(): entered
<?xml version="1.0" encoding="utf-8"?><soapenv:Envelope xmlns:soapenv="http://schemas.xmlsoap.org/soap/envelope/"; xmlns:xsd="http://www.w3.org/2001/XMLSchema"; xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance";><soapenv:Body><ns1:CARDSReferenceGateway soapenv:encodingStyle= "http://schemas.xmlsoap.org/soap/encoding/"; xmlns:ns1="urn:PegaRULES:SOAP:CARDSReferenceService:Services"><inputXML xsi:type="xsd:string"> <![CDATA[ <BPMSERVICEREQUEST> <REQUESTORID>THC</REQUESTORID> <ACCESSKEY>lertqon3ccd!98s82*3awq</ACCESSKEY> <METHODNAME>GETEDITLIST</METHODNAME> </BPMSERVICEREQUEST> ]]></inputXML></ns1:CARDSReferenceGateway></soapenv:Body></soapenv:Envelope>
recvresp(): entered
HTTP/1.1 200 OK
Date: Thu, 29 Oct 2009 04:11:32 GMT
Server: WebSphere Application Server/6.1
Content-Type: text/xml;charset=UTF-8
Content-Length: 109030
Content-Language: en-US
Set-Cookie: JSESSIONID=0000-LS0R0KZriFgV1DOF_3xaDw:-1; Path=/
Expires: Thu, 01 Dec 1994 16:00:00 GMT
Cache-Control: no-cache=set-cookie
SetError() #13: HTTP/1.1 200 OK
recvdoc parms: identity 109030
header_load_cookies() entered
cookie_parse() entered
cookie = JSESSIONID=0000-LS0R0KZriFgV1DOF_3xaDw:-1; Path=/
cookie attr jsessionid=0000-LS0R0KZriFgV1DOF_3xaDw:-1
cookie attr path=/
recvdoc(): entered
SetError() #0:
<?xml version="1.0" ?>
<SOAP-ENV:Envelope
xmlns:SOAP-ENV="http://schemas.xmlsoap.org/soap/envelope/";
xmlns:SOAP-ENC="http://schemas.xmlsoap.org/soap/encoding/";
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance";
xmlns:xsd="http://www.w3.org/2001/XMLSchema";>
<SOAP-ENV:Body>
<ns:CARDSReferenceGatewayResponse xmlns:ns="urn:PegaRULES:SOAP:CARDSReferenceService:Services" SOAP-ENV:encodingStyle="http://schemas.xmlsoap.org/soap/encoding/";>
<outputXML xsi:type="xsd:string"><Edits><Edit><EditID>IAD020_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>2</Severity><Title>Single MCC</Title><DisplayID>IAD020</DisplayID><Description>Only one MCC was assigned on this case. Please review the record to validate that it is appropriate to report the solitary MCC. Also validate that the principal diagnosis and any procedures were assigned correctly.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD040_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>2</Severity><Title>Single CC</Title><DisplayID>IAD040</DisplayID><Description>Only one CC was assigned on this case. Please review the record to validate that it is appropriate to report the solitary CC. Also validate that the principal diagnosis and any procedures were assigned correctly.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD060_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>GI disorder w/o hemorrhage and blood loss anemia</Title><DisplayID>IAD060</DisplayID><Description>Blood loss anemia and gastritis without hemorrhage are assigned. Review the record for a suspected source of the hemorrhage. Although the combination code for Gastritis with hemorrhage should not be assigned unless there is a causal relationship establis</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD080_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>2</Severity><Title>Pleural effusion and CHF</Title><DisplayID>IAD080</DisplayID><Description> Pleural effusion is not usually reported in cases of CHF/Left heart failure, as, it is commonly seen in this disease. Ordinarily, the pleural effusion is minimal and is not specifically addressed other than by more aggressive treatment of the underlying </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD080_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>2</Severity><Title>Pleural effusion and CHF</Title><DisplayID>IAD080</DisplayID><Description> Pleural effusion is not usually reported in cases of CHF/Left heart failure, as, it is commonly seen in this disease. Ordinarily, the pleural effusion is minimal and is not specifically addressed other than by more aggressive treatment of the underlying </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-20T12:50:11.330</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD100_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>BMI &gt; 30 without Obesity</Title><DisplayID>IAD100</DisplayID><Description>Two codes are needed to completely describe obesity or morbid obesity. A code from V85 should not be assigned without a physicianâ??s diagnosis of underweight or obesity. Review the record for such documentation; query the provider if indicated. If docum</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD120_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Hyponatremia with SIADH</Title><DisplayID>IAD120</DisplayID><Description>Hyponatremia is assigned as the principal diagnosis with SIADH (253.6) assigned as a secondary diagnosis. Generally only the SIADH is reported in these circumstances. Validate whether the SIADH qualifies as the principal diagnosis. Refer to AHA Coding C</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD140_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Obesity without BMI</Title><DisplayID>IAD140</DisplayID><Description>This case has a diagnosis of obesity or morbid obesity without a corresponding BMI status code. Two codes are needed to completely describe obesity or morbid obesity. Review the record, including ancillary notes, for documentation of the patientâ??s BMI.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD160_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Unspecified GI Hemorrhage</Title><DisplayID>IAD160</DisplayID><Description>A code for unspecified GI hemorrhage has been assigned. Review the record to verify a possible or established source of the GI bleed.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD160_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Unspecified GI Hemorrhage</Title><DisplayID>IAD160</DisplayID><Description>A code for unspecified GI hemorrhage has been assigned. Review the record to verify a possible or established source of the GI bleed.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-15T10:19:57.863</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD180_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Current and residual cerebrovascular disorders</Title><DisplayID>IAD180</DisplayID><Description>A DRG for acute cerebrovascular event has been assigned along with a code from category 438 (late effects of cerebrovascular disease). Category 438 is not assigned along with a current infarction or CVA unless the late effects are documented as being fro</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD200_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Pressure Ulcer without Stage</Title><DisplayID>IAD200</DisplayID><Description>A code for pressure ulcer has been assigned without a corresponding stage code. Two codes are needed to COMPLETELY describe a pressure ulcer. A code from 707.2x must accompany the 707.0x. Review the record, including nurseâ??s notes, for documentation of</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD200_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Pressure Ulcer without Stage</Title><DisplayID>IAD200</DisplayID><Description>A code for pressure ulcer has been assigned without a corresponding stage code. Two codes are needed to COMPLETELY describe a pressure ulcer. A code from 707.2x must accompany the 707.0x. Review the record, including nurseâ??s notes, for documentation of</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-21T13:58:58.693</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD220_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Pressure Ulcer Stage without Ulcer Dx</Title><DisplayID>IAD220</DisplayID><Description>Coding rules prohibit reporting 707.2x without a corresponding 707.0x code. Two codes are needed to COMPLETELY describe a pressure ulcer. The code for the ulcer stage may not be reported without the corresponding pressure ulcer diagnostic code. Review </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD220_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Pressure Ulcer Stage without Ulcer Dx</Title><DisplayID>IAD220</DisplayID><Description>Coding rules prohibit reporting 707.2x without a corresponding 707.0x code. Two codes are needed to COMPLETELY describe a pressure ulcer. The code for the ulcer stage may not be reported without the corresponding pressure ulcer diagnostic code. Review </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-23T16:22:36.097</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD240_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Pressure Ulcer Site or Stage unspecified</Title><DisplayID>IAD240</DisplayID><Description>707.00 and/or 707.20 has been assigned. Please review the record for evidence of a specific site or stage of the pressure ulcer.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD240_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Pressure Ulcer Site or Stage unspecified</Title><DisplayID>IAD240</DisplayID><Description>707.00 and/or 707.20 has been assigned. Please review the record for evidence of a specific site or stage of the pressure ulcer.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-15T10:58:25.063</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD260_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>Hemodialysis without ESRD</Title><DisplayID>IAD260</DisplayID><Description>39.95 is assigned for hemodialysis without a corresponding Dx code for acute kidney injury, ESRD (585.6) or other chronic kidney disease (CKD). Review the record for documentation of CKD. A physician query may be indicated if the physician documentation</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD280_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>CKD, Stage Unspecified</Title><DisplayID>IAD280</DisplayID><Description>585.9 for CKD unspecified has been assigned. For data quality and accurate severity scoring, the stage of the CKD should be documented in the record and the appropriate code from 585.0 â?? 585.6 should be assigned as indicated. Review the record for such </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IAD280_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>AD</CategoryID><Severity>1</Severity><Title>CKD, Stage Unspecified</Title><DisplayID>IAD280</DisplayID><Description>585.9 for CKD unspecified has been assigned. For data quality and accurate severity scoring, the stage of the CKD should be documented in the record and the appropriate code from 585.0 â?? 585.6 should be assigned as indicated. Review the record for such </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-13T00:00:00</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR020_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>1</Severity><Title>W/O CC or W/CC DRG, LOS =&gt; 90th percentile</Title><DisplayID>IDR020</DisplayID><Description>This case is assigned to a "without CC" or "with CC" DRG for this principal diagnosis, however the length of stay equals or exceeds the CMS 90th percentile LOS for this DRG nationwide. This may indicate the LOS is more consistent with that found in a hig</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR020_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>1</Severity><Title>W/O CC or W/CC DRG, LOS =&gt; 90th percentile</Title><DisplayID>IDR020</DisplayID><Description>This case is assigned to a "without CC" or "with CC" DRG for this principal diagnosis, however the length of stay equals or exceeds the CMS 90th percentile LOS for this DRG nationwide. This may indicate the LOS is more consistent with that found in a hig</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-13T00:00:00</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR040_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>With CC or W/ MCC DRG, LOS &lt;= 25th percentile</Title><DisplayID>IDR040</DisplayID><Description>This case is assigned to a "with CC" or "with MCC" DRG, however the length of stay is less than the CMS 25th percentile for this DRG nationwide. This may indicate the LOS is more consistent with that found in a lower severity DRG. Please review the circ</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR040_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>With CC or W/ MCC DRG, LOS &lt;= 25th percentile</Title><DisplayID>IDR040</DisplayID><Description>This case is assigned to a "with CC" or "with MCC" DRG, however the length of stay is less than the CMS 25th percentile for this DRG nationwide. This may indicate the LOS is more consistent with that found in a lower severity DRG. Please review the circ</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-13T00:00:00</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR060_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>Stastically Infrequent DRG</Title><DisplayID>IDR060</DisplayID><Description>The DRG assigned on this case is in the bottom 5th percentile of all DRGs processed by Medicare nationwide. Please review the record to validate that this DRG is correct prior to final coding.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR060_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>Stastically Infrequent DRG</Title><DisplayID>IDR060</DisplayID><Description>The DRG assigned on this case is in the bottom 5th percentile of all DRGs processed by Medicare nationwide. Please review the record to validate that this DRG is correct prior to final coding.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-15T08:26:38.567</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR080_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>Full Review DRG: Extensive OR procedure unrelated to principal diagnosis</Title><DisplayID>IDR080</DisplayID><Description>Please validate the diagnosis and procedure coding on this case with particular attention to the diagnosis sequencing that caused this case to group to DRG 981, 982 or 983.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR080_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>Full Review DRG: Extensive OR procedure unrelated to principal diagnosis</Title><DisplayID>IDR080</DisplayID><Description>Please validate the diagnosis and procedure coding on this case with particular attention to the diagnosis sequencing that caused this case to group to DRG 981, 982 or 983.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-13T14:10:02.940</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR100_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>Invalid DRG</Title><DisplayID>IDR100</DisplayID><Description>The encoder has returned DRG 999 as the final coded DRG. Please return to the encoder and validate all code, disposition and POA assignment.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR100_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>Invalid DRG</Title><DisplayID>IDR100</DisplayID><Description>The encoder has returned DRG 999 as the final coded DRG. Please return to the encoder and validate all code, disposition and POA assignment.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-15T11:27:46.880</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR120_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>HIV, no major related condition, LOS &gt; 75%ile</Title><DisplayID>IDR120</DisplayID><Description>DRG 977, HIV w or w/o related condition has been assigned with a length of stay more consistent with those patients who have HIV with a major related condition. Review the record for evidence of a major related condition such as candidiasis, Kaposi's sar</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR120_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>HIV, no major related condition, LOS &gt; 75%ile</Title><DisplayID>IDR120</DisplayID><Description>DRG 977, HIV w or w/o related condition has been assigned with a length of stay more consistent with those patients who have HIV with a major related condition. Review the record for evidence of a major related condition such as candidiasis, Kaposi's sar</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-15T12:01:31.920</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR140_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>1</Severity><Title>Angina without CAD</Title><DisplayID>IDR140</DisplayID><Description>This case is assigned to MS-DRG 311, Angina Pectoris with an LOS &gt; 75th percentile for this DRG. Validate whether an underlying cause of the angina was identified as this may have contributed to the increased Length of Stay. If an underlying cause was i</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR160_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>1</Severity><Title>Cardiac Catheterization in Non circulatory DRG</Title><DisplayID>IDR160</DisplayID><Description>A cardiac cath has been assigned in a non-circulatory DRG. Review the physician documentation to determine whether the principal diagnosis has been assigned accurately.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR180_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>1</Severity><Title>Angina as principal, CAD secondary</Title><DisplayID>IDR180</DisplayID><Description>This case is assigned to MS-DRG 311, Angina Pectoris with a code for CAD as secondary. Coding Guidelines dictate that if the CAD is related to the Angina, the CAD should be sequenced as principal. See AHA Coding Clinic, Second Quarter 2004 Page: 3 to 4 </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR200_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>1</Severity><Title>Cardiac Arrest, unexplained LOS &gt; 2</Title><DisplayID>IDR200</DisplayID><Description>A DRG for Cardiac arrest, unexplained has been assigned with the LOS greater than two days. Please review the record for a possible cause of the cardiac arrest and possible principal diagnosis clarification.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR220_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>Full Review DRGs: DRG 190 with pneumonia</Title><DisplayID>IDR220</DisplayID><Description>The circumstances of admission always govern the selection of principal diagnosis. Please review and validate the sequencing of COPD followed by pneumonia. Document the factor(s) that led to this sequencing decision.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR240_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>DRG 488/489 with Infection as Secondary Diagnosis</Title><DisplayID>IDR240</DisplayID><Description>This case has been assigned to a "knee procedure without PDx of Infection" MS-DRG but has a secondary diagnosis of infection. Validate whether the infection should be sequenced as the principal diagnosis.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR260_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>1</Severity><Title>Potential encounter for dialysis</Title><DisplayID>IDR260</DisplayID><Description>This patient is assigned Chronic Kidney Disease as principal diagnosis, received dialysis and had a short length of stay. When a patient is seen solely for dialysis treatment, code V56.0, Encounter for dialysis and dialysis catheter care, Extracorporeal </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR280_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>1</Severity><Title>DRG 689 (Kidney and UTI with MCC), LOS &gt; 75%ile</Title><DisplayID>IDR280</DisplayID><Description>A UTI or other genitourinary infection has been assigned as principal with an Length of Stay more consistent with those patients who have a generalized infection. Validate that there was not a generalized infection that caused this admission and contribu</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR280_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>1</Severity><Title>DRG 689 (Kidney and UTI with MCC), LOS &gt; 75%ile</Title><DisplayID>IDR280</DisplayID><Description>A UTI or other genitourinary infection has been assigned as principal with an Length of Stay more consistent with those patients who have a generalized infection. Validate that there was not a generalized infection that caused this admission and contribu</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-15T12:28:56.433</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR300_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>Full Review DRG: Other factors influencing health status</Title><DisplayID>IDR300</DisplayID><Description>A diagnosis/symptom code should be used whenever a current, acute diagnosis is being treated or a sign or symptom is being studied. Review the record to validate the accuracy of the principal diagnosis.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IDR300_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>DR</CategoryID><Severity>2</Severity><Title>Full Review DRG: Other factors influencing health status</Title><DisplayID>IDR300</DisplayID><Description>A diagnosis/symptom code should be used whenever a current, acute diagnosis is being treated or a sign or symptom is being studied. Review the record to validate the accuracy of the principal diagnosis.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-15T12:16:38.293</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IOT020_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>OT</CategoryID><Severity>1</Severity><Title>Post-acute Care Disposition</Title><DisplayID>IOT020</DisplayID><Description>One of the CMS â??post-acute careâ?? DRGs has been assigned and the disposition indicates no post-acute care services were ordered. CMS requires transfers to home health, SNF, Rehab or another acute care facility to be reimbursed at a calculated per diem ra</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD020_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>Questionable Admission</Title><DisplayID>IPD020</DisplayID><Description>The principal diagnosis on this case is on Medicare's list of Questionable admissions. The diagnoses on this list are not usually sufficient justification for admission to an acute care hospital. Please address principal diagnosis selection and if corre</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD020_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>Questionable Admission</Title><DisplayID>IPD020</DisplayID><Description>The principal diagnosis on this case is on Medicare's list of Questionable admissions. The diagnoses on this list are not usually sufficient justification for admission to an acute care hospital. Please address principal diagnosis selection and if corre</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-20T13:24:07.420</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD040_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>Sepsis as Pdx, LOS &lt; 4</Title><DisplayID>IPD040</DisplayID><Description>A DRG for Septicemia has been assigned with a relatively short LOS. Review the record for evidence that the sepsis/septicemia was ruled out in favor of another diagnosis. A physician query may be indicated if the physician documentation is unclear, inco</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD060_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Septicemia as Sdx</Title><DisplayID>IPD060</DisplayID><Description>From the NCHS official coding guidelines, "if sepsis or severe sepsis is present on admission, and meets the definition of principal diagnosis, the systemic infection code (e.g., 038.xx, 112.5, etc.) should be assigned as the principal diagnosis, followed</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD080_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Malignancy and Pneumonia</Title><DisplayID>IPD080</DisplayID><Description>The circumstances of admission always govern the selection of principal diagnosis. Review the physician documentation to determine if the reason for admission is the malignancy or the pneumonia. Refer to the chapter specific Neoplasm and Pnaumonia codin</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD100_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Malignancy Sequencing</Title><DisplayID>IPD100</DisplayID><Description>Malignant neoplasms are sequenced according to the circumstances of admission. Review the physician documentation to determine if the reason for admission is the primary or the secondary malignancy. Refer to the chapter-specific Neoplasm coding guidelin</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD120_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>Malignancy followed by Anemia, Short LOS</Title><DisplayID>IPD120</DisplayID><Description>A malignancy code is assigned as the principal diagnosis with anemia as a secondary diagnosis. Per the NCHS Coding guidelines, "when admission/encounter is for management of an anemia associated with the malignancy, and the treatment is only for anemia, </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD140_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Non-specific neoplasm</Title><DisplayID>IPD140</DisplayID><Description>A non-specific neoplasm is assigned as the PDX. Review the record to determine if a more specified neoplasm can be identified.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD140_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Non-specific neoplasm</Title><DisplayID>IPD140</DisplayID><Description>A non-specific neoplasm is assigned as the PDX. Review the record to determine if a more specified neoplasm can be identified.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-20T14:41:04.380</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD160_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Anemia with endoscopy</Title><DisplayID>IPD160</DisplayID><Description>Anemia has been assigned as the principal diagnosis with a digestive system procedure. Review the record to validate whether the focus of treatment and diagnostic workup indicates a digestive diagnosis versus anemia. </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD180_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>White blood cell disorder as principal followed by Malignancy</Title><DisplayID>IPD180</DisplayID><Description>A principal diagnosis of a white blood cell disorder has been assigned as principal diagnosis followed by a code for malignancy. Review the record for appropriate sequencing of the neoplasm and the white blood cell disorder code. If treatment is directe</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD200_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Potential Diabetic Complication as principal diagnosis</Title><DisplayID>IPD200</DisplayID><Description>Diabetes with other specified Manifestations, Unspecified Diabetes or Unspecified Secondary Diabetes is assigned as the principal diagnosis followed by a secondary diagnosis of a specified diabetic-related complication. Review the medical record documenta</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD220_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Potential diabetic nephropathy as Pdx</Title><DisplayID>IPD220</DisplayID><Description>A renal disorder has been assigned as principal diagnosis with diabetes as an additional diagnosis. Coding Clinic 1Q 2003 p. 20-21 indicates that if the underlying cause of the renal condition is diabetic nephropathy, the appropriate code from subcategor</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD240_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Syncope with Arrhythmia</Title><DisplayID>IPD240</DisplayID><Description>Codes for Syncope and cardiac arrhythmia are present. Symptom codes should not be reported when a related, definitive diagnosis is present. Review the record to determine if syncope is a separately reportable condition. If it was determined to be a comp</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD260_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Metabolic condition followed by digestive condition, longer LOS</Title><DisplayID>IPD260</DisplayID><Description>A metabolic or immunologic condition has been assigned as principal diagnosis with a digestive diagnosis assigned as secondary. This sequencing has historically been an area of OIG focus. The Length of Stay is also above the 75th percentile for the DRG a</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD280_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Chest Pain with Cocaine Abuse</Title><DisplayID>IPD280</DisplayID><Description>Chest pain is assigned as the principal diagnosis with cocaine abuse as a secondary diagnosis. If the patient presented with cocain-induced chest pain, AHA Coding Clinic 1Q 1993, page 25 directs code 970.8 is to be assigned as PDX.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD300_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Hypertensive CV disease without heart failure</Title><DisplayID>IPD300</DisplayID><Description>Hypertensive cardiovascular disease without congestive heart failure is assigned as the principal diagnosis. As this code tends to represent a chronic condition not necessating acute hospitalization, please review the record to validate this principal d</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD320_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>MI as Secondary Diagnosis</Title><DisplayID>IPD320</DisplayID><Description>Acute Myocardial Infarction (AMI) has been noted as being present on admission and assigned as an additional diagnosis. Review the record to determine whether AMI meets the definition of principal diagnosis. </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD340_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>MI and Respiratory Failure</Title><DisplayID>IPD340</DisplayID><Description>Coding Clinic has clarified that conditions such as Acute Myocardial Infarction with Respiratory Failure are sequenced according to the circumstances of admission. Please review the record to determine which condition the physician documentation supports</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD360_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Acute MI as secondary diagnosis</Title><DisplayID>IPD360</DisplayID><Description>An acute myocardia infarction, initial eipsode of care (POA = "Y") has been assigned as a secondary diagnosis. In these situations it is more common to see the MI sequenced as principal if it was the condition responsible for occasioning the admission. </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD380_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Arrythmia followed by CHF</Title><DisplayID>IPD380</DisplayID><Description>The circumstances of admission always govern the selection of principal diagnosis. Review the record to validate whether the arrythmia or CHF should be principal diagnosis.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD400_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>CHF and Respiratory Failure</Title><DisplayID>IPD400</DisplayID><Description>Coding Clinic has clarified that conditions such as CHF with Respiratory Failure are sequenced according to the circumstances of admission. Please review the record to confirm the condition the physician documentation supports as being responsible for oc</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD420_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>CVA and Respiratory Failure</Title><DisplayID>IPD420</DisplayID><Description>Coding Clinic has clarified that conditions such as Acute Myocardial Infarction with Respiratory Failure are sequenced according to the circumstances of admission. Please review the record to determine which condition the physician documentation supports</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD440_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>Bacterial Pneumonia Verification</Title><DisplayID>IPD440</DisplayID><Description>This case has 482.83 or 482.89 assigned as the principal diagnosis. These two diagnosis codes should be rarely used. A diagnostic statement of "bacterial pneumonia" would be assigned to 482.9. Please verify the appropriateness of the principal diagnosis</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD440_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>Bacterial Pneumonia Verification</Title><DisplayID>IPD440</DisplayID><Description>This case has 482.83 or 482.89 assigned as the principal diagnosis. These two diagnosis codes should be rarely used. A diagnostic statement of "bacterial pneumonia" would be assigned to 482.9. Please verify the appropriateness of the principal diagnosis</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-15T13:07:40.963</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD460_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Exacerbation of COPD followed by Heart Failure</Title><DisplayID>IPD460</DisplayID><Description>The circumstances of admission always govern the selection of principal diagnosis. Please review and validate the sequencing of 491.21 followed by 428.xx. Document the factor(s) that led to this sequencing decision.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD480_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>COPD followed by pneumonia</Title><DisplayID>IPD480</DisplayID><Description>COPD/Asthma/Bronchitis has been assigned as principal diagnosis with pneumonia as a secondary diagnosis. Although many patients present with pneumonia and COPD seemingly â??co-equalâ??, often it is the pneumonia that will necessitate inpatient treatment. Re</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD500_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Secondary Aspiration Pneumonia POA = Y</Title><DisplayID>IPD500</DisplayID><Description>Aspiration pneumonia has been assigned as a secondary diagnosis with a POA of "Y". Please validate the POA indicator.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD520_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>2</Severity><Title>Digestive condition followed by metabolic condition, shorter LOS</Title><DisplayID>IPD520</DisplayID><Description>A digestive diagnosis has been assigned as principal diagnosis with a metabolic or immunologic conditionassigned as secondary. This sequencing has historically been an area of OIG focus. The Length of Stay is also below the 25th percentile for the DRG a</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD540_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Crohn's or ulcerative colitis as secondary diagnosis</Title><DisplayID>IPD540</DisplayID><Description>555.x Crohn's Disease or 556.x, ulcerative colitis is assigned as an additional diagnosis with another GI condition as principal diagnosis. Per CC 1Q 2003. p. 18, determine if the other GI condition is stated to be secondary to the Crohn's or ulcerative </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD560_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Cellulitis Sequencing</Title><DisplayID>IPD560</DisplayID><Description>The circumstances of admission always govern the selection of principal diagnosis. Review the physician documentation to determine if the reason for admission is the cellulitis or the pressure ulcer. Coding Clinic Q2 91, p, 5-7, "If the patient is seen </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD580_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Pregnancy code as secondary diagnosis</Title><DisplayID>IPD580</DisplayID><Description>A non-pregnancy code is assigned as PDX in this case followed by a secondary diagnosis code of a pregnancy-related condition. The Chapter-specific guidelines for obstetric coding guidelines state that when a patient is admitted to the hospital and is also</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD600_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Chest pain and Angina</Title><DisplayID>IPD600</DisplayID><Description>Chest pain is assigned as the principal diagnosis with angina as a secondary diagnosis. If the chest pain is related to the angina, code only the angina. Validate principal diagnosis selection.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD620_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Symptom as PDx, Long Length of Stay</Title><DisplayID>IPD620</DisplayID><Description>A symptom code is assigned as the principal diagnosis with a long length of stay. A symptom code is not assigned as the principal diagnosis when a related definitive diagnosis has been established. Validate the sequencing on this case.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD640_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>UTI with bacteremia</Title><DisplayID>IPD640</DisplayID><Description>UTI/pyelonephritis is assigned as the principal diagnosis with bacteremia secondary. Physicians often use the terms "urosepsis", "bacteremia" and "septicemia"/"sepsis"/"SIRS" interchangebly. Review the record for evidence of a systemic, generalized infe</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD660_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Asymptomatic HIV status</Title><DisplayID>IPD660</DisplayID><Description>From the official coding guidelines: "V08 Asymptomatic human immunodeficiency virus [HIV] infection, is to be applied when the patient without any documentation of symptoms is listed as being "HIV positive," "known HIV," "HIV test positive," or similar te</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD660_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Asymptomatic HIV status</Title><DisplayID>IPD660</DisplayID><Description>From the official coding guidelines: "V08 Asymptomatic human immunodeficiency virus [HIV] infection, is to be applied when the patient without any documentation of symptoms is listed as being "HIV positive," "known HIV," "HIV test positive," or similar te</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-19T11:09:01.273</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPD680_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PD</CategoryID><Severity>1</Severity><Title>Unspecified Birth</Title><DisplayID>IPD680</DisplayID><Description>It is uncommon to see a code from Category V33, Twin birth unspecified, V37, Multiple birth unspecified, or V39, Liveborn, unspecified, assigned in the inpatient setting. Please verify accuracy of the newborn code prior to final coding.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPO020_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PO</CategoryID><Severity>1</Severity><Title>Pressure ulcer not POA</Title><DisplayID>IPO020</DisplayID><Description>There is a potential POA mismatch between the pressure ulcer site code and the pressure ulcer stage code. The site code with a POA of "N" should have a corresponding stage code with a POA of "N". Please validate the appropriateness of the POA assignment</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPO040_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PO</CategoryID><Severity>2</Severity><Title>Catheter Infection POA = Y</Title><DisplayID>IPO040</DisplayID><Description>A catheter infection listed as being present on admission is assigned as a secondary diagnosis. If the manifestation of the complication is the reason for admission, the complication must be sequenced as principal. If the infection was hospital-acquired</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPO060_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PO</CategoryID><Severity>1</Severity><Title>Complication as secondary, POA = "Y"</Title><DisplayID>IPO060</DisplayID><Description>A complication code with a POA of "Y" has been assigned as an additional diagnosis. If the reason for admission is because of the complication, the complication code should ordinarily be sequenced as principal diagnosis. Validate the principal diagnosis</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR020_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>1</Severity><Title>Carotid PTA without Stent</Title><DisplayID>IPR020</DisplayID><Description>A carotid PTA has been assigned without a carotid stent. Medicare considers a carotid PTA "non-covered" unless it also performed with a stent procedure. Review the record to determine whether a stent was inserted.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR020_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>1</Severity><Title>Carotid PTA without Stent</Title><DisplayID>IPR020</DisplayID><Description>A carotid PTA has been assigned without a carotid stent. Medicare considers a carotid PTA "non-covered" unless it also performed with a stent procedure. Review the record to determine whether a stent was inserted.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-19T13:42:28.777</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR040_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>1</Severity><Title>Carotid stent needs to be in first six positions</Title><DisplayID>IPR040</DisplayID><Description>A carotid PTA has been assigned with a carotid stent, however with the current procedure sequencing, payers may not process the 00.63 code and the claim may be denied. Medicare considers a carotid PTA "non-covered" unless it also performed with a stent p</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR100_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>1</Severity><Title>Tracheostomy without invasive mechanical ventilation</Title><DisplayID>IPR100</DisplayID><Description>A tracheostomy has been coded. Tracheostomies are commonly associated with invasive mechanical ventilation but no code from subcategory 96.7 has been assigned. Validate the tracheostomy and whether the patient received invasive mechanical ventilation. </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR200_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>2</Severity><Title>Full Review DRGs: excisional debridement</Title><DisplayID>IPR200</DisplayID><Description>Please review and documentation the location in the record that supports assigning 86.22, excisional debridement.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR200_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>2</Severity><Title>Full Review DRGs: excisional debridement</Title><DisplayID>IPR200</DisplayID><Description>Please review and documentation the location in the record that supports assigning 86.22, excisional debridement.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-19T15:59:39.747</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR400_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>1</Severity><Title>Mechanical Ventilation, Extended LOS</Title><DisplayID>IPR400</DisplayID><Description>The length of stay of this case is comporable to patients who receive a tracheostomy. Please review the progress notes or procedure record and validate whether a tracheostomy was or was not performed.</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR500_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>2</Severity><Title>Mechanical ventilation hours</Title><DisplayID>IPR500</DisplayID><Description>The length of stay is less than 96 hours yet code 96.72 for continuous invasive mechanical ventilation 96+ hours has been assigned. Please validate the start and stop times of mechanical ventilation for this patient and whether code 96.71, invasive mecha</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR500_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>2</Severity><Title>Mechanical ventilation hours</Title><DisplayID>IPR500</DisplayID><Description>The length of stay is less than 96 hours yet code 96.72 for continuous invasive mechanical ventilation 96+ hours has been assigned. Please validate the start and stop times of mechanical ventilation for this patient and whether code 96.71, invasive mecha</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-19T16:25:18.073</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IPR600_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>PR</CategoryID><Severity>1</Severity><Title>ESRD without Hemodialysis</Title><DisplayID>IPR600</DisplayID><Description>585.6 is assigned for ESRD without a corresponding procedure code for hemodialysis. CMS defines ESRD as CKD requiring dialysis. Review the record for documentation of dialysis and if reported, assure that the 39.95 is in one of the first six procedure c</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE110_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Wrong Site Surgery</Title><DisplayID>IRE110</DisplayID><Description>This patient is assigned an E Code for a surgical procedure on the wrong site/body part (right patient). Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT release</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE110_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Wrong Site Surgery</Title><DisplayID>IRE110</DisplayID><Description>This patient is assigned an E Code for a surgical procedure on the wrong site/body part (right patient). Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT release</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-19T16:48:15.833</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE120_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Wrong Patient Surgery</Title><DisplayID>IRE120</DisplayID><Description>This patient is assigned an E Code for a surgical procedure on the wrong patient. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT release the claim until the HC</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE120_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Wrong Patient Surgery</Title><DisplayID>IRE120</DisplayID><Description>This patient is assigned an E Code for a surgical procedure on the wrong patient. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT release the claim until the HC</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-20T08:45:51.317</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE130_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Wrong Procedure</Title><DisplayID>IRE130</DisplayID><Description>This patient is assigned an E Code for wrong procedure on a correct patient. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT release the claim until the HCO or d</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE130_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Wrong Procedure</Title><DisplayID>IRE130</DisplayID><Description>This patient is assigned an E Code for wrong procedure on a correct patient. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT release the claim until the HCO or d</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-20T09:12:01.627</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE140_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Retained foreign body (HAC)</Title><DisplayID>IRE140</DisplayID><Description>This patient is assigned a complication code that could indicate a retained foreign body during the hospital stay. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NO</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE200_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Contaminated Drug, Device or Biologics</Title><DisplayID>IRE200</DisplayID><Description>This patient is a death potentially associated with a contaminated drug, device or biologic. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event DO NOT release the claim unti</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE210_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Function of a Device</Title><DisplayID>IRE210</DisplayID><Description>This patient is a potential death due to theuse or function of a device in which the device is used for functions other than as intended. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Re</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE230_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Air Embolism (HAC)</Title><DisplayID>IRE230</DisplayID><Description>This patient is assigned a diagnosis code for the HAC category "Air Embolism". Please verify the code and POA designation of "N" or "U". As indicated, refer the case to the HCO prior to final billing to address possible non-covered charges. </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE330_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Patient Suicide</Title><DisplayID>IRE330</DisplayID><Description>This patient is a death due to potential suicide or from sequela related to an attempted suicide while a patient. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NO</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE410_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Medication Error</Title><DisplayID>IRE410</DisplayID><Description>This patient is assigned complication codes that may indicate patient death or serious disability associated with a medicaion error. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Report</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE415_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Medication Error - Wrong Dose, Drug, etc</Title><DisplayID>IRE415</DisplayID><Description>This patient is a death potentially due to wrong dose, drug, patient, time, rate, preparation or route of medication. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE420_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Hemolytic Reaction (HAC)</Title><DisplayID>IRE420</DisplayID><Description>This patient is assigned complication codes that may indicate patient death or serious disability associated with a hemolytic reaction. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Rep</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE425_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Significant Allergic Reaction</Title><DisplayID>IRE425</DisplayID><Description>ICD-9-CM code(s) and POA indicator(s) have been assigned indicating a potentially severe allergic reaction. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT relea</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE430_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Maternal Death</Title><DisplayID>IRE430</DisplayID><Description>This patient is a death potentially associated with labor or delivery in a low-risk pregnancy. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event (clinicians may determine th</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE430_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Maternal Death</Title><DisplayID>IRE430</DisplayID><Description>This patient is a death potentially associated with labor or delivery in a low-risk pregnancy. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event (clinicians may determine th</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-20T10:17:27.517</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE440_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Poor Glycemic Control (HAC)</Title><DisplayID>IRE440</DisplayID><Description>This patient is assigned a diagnosis code for the HAC category "Poor Glycemic Control". Please verify the code and POA designation of "N" or "U". As indicated, refer the case to the HCO prior to final billing to address possible non-covered charges. </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE450_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Hyperbilirubinemia</Title><DisplayID>IRE450</DisplayID><Description>This patient is a death potentially associated with failure to identify and treat hyperbilirubinemia. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event DO NOT release the c</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE460_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Pressure ulcer (Stage III/IV) (HAC)</Title><DisplayID>IRE460</DisplayID><Description>This patient is assigned a diagnosis code for the HAC category "Pressure Ulcer". Please verify the code and POA designation of "N" or "U". As indicated, refer the case to the HCO prior to final billing to address possible non-covered charges. </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE470_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Spinal Manipulative Therapy</Title><DisplayID>IRE470</DisplayID><Description>This patient is a death potentially associated with spinal manipulative therapy. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event DO NOT release the claim until the HCO or</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE480_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Artifical Insemination</Title><DisplayID>IRE480</DisplayID><Description>This patient is assigned a procedure code of artifical insemination with a complication code that could indicate artifical insemination with the wrong donor sperm or donor egg. Please validate the coding. If the coding is correct notify your risk manage</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE480_01</EditID><EffectiveDate>2009-10-01T00:00:00</EffectiveDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Artifical Insemination</Title><DisplayID>IRE480</DisplayID><Description>This patient is assigned a procedure code of artifical insemination with a complication code that could indicate artifical insemination with the wrong donor sperm or donor egg. Please validate the coding. If the coding is correct notify your risk manage</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-20T11:05:57.133</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE510_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Shock or Cardioversion</Title><DisplayID>IRE510</DisplayID><Description>This patient is assigned complication codes that may indicate patient death or serious disability associated with a electric shock or cardioversion. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potentia</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE530_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Burn</Title><DisplayID>IRE530</DisplayID><Description>This patient is a death potentially due to burn while being cared for in the hospital. Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT release the claim until the</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE540_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Patient Fall</Title><DisplayID>IRE540</DisplayID><Description>This patient is assigned complication codes that may indicate patient death or serious disability associated with a fall while being cared for in a healthcare facility. Please validate the coding. If the coding is correct notify your risk manager or HC</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE580_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Sexual Assault</Title><DisplayID>IRE580</DisplayID><Description>This patient is assigned codes for sexual assault while being cared for in the hospital (i.e. not POA). Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT release th</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE590_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Physical Assault</Title><DisplayID>IRE590</DisplayID><Description>This patient is assigned codes for physical assault while being cared for in the hospital (i.e. not POA). Please validate the coding. If the coding is correct notify your risk manager or HCO about the potential Serious Reportable Event. DO NOT release </Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE610_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>2</Severity><Title>Potential Serious Reportable Event: Postoperative DVT-PE Following Hip/Knee Replacement (HAC)</Title><DisplayID>IRE610</DisplayID><Description>This patient is assigned a diagnosis code for the HAC category "Postoperative Deep Venous Thrombosis/Pulmonary Embolism". Please verify the code and POA designation of "N" or "U". As indicated, refer the case to the HCO prior to final billing to address</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit><Edit><EditID>IRE620_00</EditID><EffectiveDate>2008-10-01T00:00:00</EffectiveDate><EndDate>2009-09-30T23:59:59.997</EndDate><ClassificationID>I</ClassificationID><CategoryID>RE</CategoryID><Severity>1</Severity><Title>Potential Serious Reportable Event: CAUTI or Vascular Cath Infection (HAC)</Title><DisplayID>IRE620</DisplayID><Description>Catheter Associated UTI and vascular catheter infection are each a Medicare's Hospital Acquired Condition. Please validate the appropriateness of both the 996.64 or 996.62 code and the POA of "N".</Description><ContinueProcessingWhenMet>1</ContinueProcessingWhenMet><LastUpdatedDate>2009-10-08T16:50:22.873</LastUpdatedDate><LastUpdatedBy>InitialLoad</LastUpdatedBy></Edit></Edits></outputXML>
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