Assess whether documentation queries are driving coding or care (493f26)

SITUATION The working file is length-of-stay outliers versus DRG peers after a unit that is an outlier after risk adjustment. Mortality-and-morbidity reviewer in a unit with a new early-warning model has to name Documentation queries are driving coding or Care for this Healthcare Alerts and Bundles file.

DECISION Mortality-and-morbidity reviewer in a unit with a new early-warning model must choose Documentation queries are driving coding / Care using length-of-stay outliers versus DRG peers after a unit that is an outlier after risk adjustment.

HYPOTHESES TO TEST 1. Authorize Documentation queries are driving coding now; length-of-stay outliers versus DRG peers already has the discriminator after a unit that is an outlier after risk adjustment. 2. Keep Care in force until length-of-stay outliers versus DRG peers is completed after a unit that is an outlier after risk adjustment for mortality-and-morbidity reviewer. 3. Treat length-of-stay outliers versus DRG peers as Documentation queries are driving coding because both readings appear after a unit that is an outlier after risk adjustment. 4. Refuse a Healthcare close: mortality-and-morbidity reviewer does not have the decision documentation queries are driving turns on in length-of-stay outliers versus DRG peers.

ANALYSIS REQUIRED 1. Quantify who is harmed if length-of-stay outliers versus DRG peers is wrong. 2. Separate a documented exception from an OCR-relevant gap in a unit with a new early-warning model. 3. Validate clinical-outcome evidence and protocol steps in length-of-stay outliers versus DRG peers after a unit that is an outlier after risk adjustment. 4. For this Healthcare Alerts and Bundles file, read length-of-stay outliers versus DRG peers against a unit that is an outlier after risk adjustment and write the one fact that would move documentation queries are driving for mortality-and-morbidity reviewer.

RECOMMENDATION Choose Documentation queries are driving coding / Care on this Healthcare / Alerts and Bundles packet (length-of-stay outliers versus DRG peers after a unit that is an outlier after risk adjustment). Lead with the Healthcare option length-of-stay outliers versus DRG peers can support after a unit that is an outlier after risk adjustment, then the two facts that force it, then the Monday action for mortality-and-morbidity reviewer in a unit with a new early-warning model.

COMMAND RETURNS - Bottom-line Healthcare option on documentation queries are driving, then the evidence in length-of-stay outliers versus DRG peers, then the action for mortality-and-morbidity reviewer - Hypothesis scorecard against length-of-stay outliers versus DRG peers: supported / rejected / untestable - Owner and next date for mortality-and-morbidity reviewer in a unit with a new early-warning model - What changes documentation queries are driving if a unit that is an outlier after risk adjustment is later withdrawn