Malnutrition denials/downgrades are dramatically up since 2018
Here’s What to Do
Since 2018, we have been hearing from Revenue Cycle leaders all about their frustration over Malnutrition, Sepsis, and Obesity Denials/DRG Downgrades. From coding to CDI to appeals – virtually the entire community is struggling with reimbursement for these very common diagnoses.
Unfortunately, these three diagnoses seem to be triggering an elevated negative response rate from nearly all payers. Your best bet is to be absolutely sure that anyone coding, appealing a denial, or improving clinical documentation for these diagnoses is following the up to date standard.
Here is a short write-up for the Malnutrition Standard