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Revisiting Respiratory Failure Claims: Proactive Approaches to Minimize Denials

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Presenter Nancy L Reading RN, BS, CPC, CPC-P, CPC-I
Broadcast Date 2/26/2025
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
1 CEU
A
Coding Billing Auditing Compliance Management
Revisiting Respiratory Failure Claims: Proactive Approaches to Minimize Denials Webinar

Learn more about this event

This webinar will educate the attendee on the normal anatomy and physiology of the respiratory system. Then the presenter will go over the pathophysiology of respiratory failure to look for to enable the coder to do the following:

a. Look for clinical parameters to support the diagnosis of respiratory failure
b. Appeal Denials based on clinical criteria
c. Set up a working check list for coders and CDIs to determine when a query is needed.
d. Sit down with a physician champion and knowledgably discuss issues at your facility or in your practice.

The webinar will provide coding guidelines for selecting the correct diagnosis between acute respiratory failure, versus chronic respiratory failure and Acute on Chronic respiratory failure. We will look at underlying etiologies and how they should be coded and sequenced.

We will review several clinical/coding samples and work through the challenges they present.

Learning Objectives/Agenda

• Understand what needs to be in the record to support the diagnosis of respiratory failure
• Understand the normal anatomy and physiology of the respiratory system
• Understand the difference between venous and arterial blood gas results and what they mean
• Identify treatments aimed at respiratory failure
• Select the correct codes for respiratory failure (acute, versus chronic versus acute on chronic)
• Identify sequencing issues for respiratory failure and other comorbid conditions
• Review capturing underlying versus acute etiology diagnosis codes for respiratory failure.
• Identify when it is appropriate ti code for respiratory failure in the postoperative setting.

Why is this topic important?

The diagnoses for respiratory failure are one of the leading reasons for claims denials and DRG down grades. Coders are listing Respiratory failure for post operative care that is routine for some situations, impacting both their denials rates and their health grades.

Who would benefit from this topic?

• Inpatient Hospital Coders
• Emergency Room/Trauma Coders
• Critical Care/Hospitalist Coders
• Pulmonology Coders
• Cardiothoracic Surgery Coders
• Anesthesia Coders
• Anyone who wants to learn something new!

Nancy L Reading RN, BS, CPC, CPC-P, CPC-I

About The Author

Nancy L Reading RN, BS, CPC, CPC-P, CPC-I

Ms. Reading has worked 42 years in Healthcare as a Nurse and Coder. She has worked in the Professional, Hospital Outpatient and Hospital Inpatient settings. Her career includes having her own consulting business, working for a large University Medical Centers, Medicaid, and as a Medicare specialist for the country’s largest private third party payer. She is a 2 time past Local Chapter president, national advisory board member and previously worked for AAPC as VP of Education. Nancy is currently the Director of Coding for Robin Healthcare.

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Two ways to register for this event
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