Sepsis Claims Denials: An Ounce of Prevention

Session Description: 

Due to variation in the sepsis definitions and clinical criteria used, healthcare organizations, coders, frontline providers, and data abstractors often encounter confusion, reimbursement denials, and multiple clinical documentation queries. In this session, Dr. Sean Townsend will review the differences between Sepsis-2 and Sepsis-3 definitions and discuss countermeasures that can be used to avoid sepsis claims denials.  

This session was originally presented in September 2021 as part of the 2021 Sepsis Alliance Summit.

Target Audience

Nurses, Advanced Practice Providers, Physicians, Emergency Responders, Pharmacists, Medical Technologists, Respiratory Therapists, Physical/ Occupational Therapist, Social Workers, Mental Health Professionals, Students, IT Professionals, Sepsis Survivors, Advocates, and more!

Learning Objectives

At the end of the presentation, the attendee should be able to:

  • Understand the difference between Sepsis-2 and Sepsis-3 definitions.
  • Recognize claims for sepsis care are being denied based on varied definitions in the literature.
  • Deploy preventative countermeasures to avoid sepsis claims denials.
Course summary
Available credit: 
  • 1.00 Participation
  • 1.30 RN CE Contact Hours
    Provider approved by the California Board of Registered Nursing, Provider Number CEP17068.
Course opens: 
06/15/2019
Course expires: 
12/31/2024

Sean R. Townsend, MD

Vice President of Quality & Safety, California Pacific Medical Center (CPMC) San Francisco, California

Clinical Associate Professor of Medicine, University of California, San Francisco

Dr. Sean R. Townsend, M.D., is Vice President of Quality & Safety at California Pacific Medical Center (CPMC) in San Francisco, California.  He is also Clinical Associate Professor of Medicine at University of California, San Francisco.  Dr. Townsend is a practicing intensivist in the Division of Pulmonary and Critical Care at CPMC.  Dr. Townsend led IHI's work on sepsis and served on the Surviving Sepsis Campaign (SSC) steering committee for many years.  Dr. Townsend serves as measure steward for CMS’s national sepsis quality measure, SEP-1. 

Provider approved by the California Board of Registered Nursing, Provider Number CEP17068 for 1.3 contact hours.

Other healthcare providers will receive a certificate of attendance for 1.0 contact hours.

Medical Disclaimer

The information on or available through this site is intended for educational purposes only. Sepsis Alliance does not represent or guarantee that information on or available through this site is applicable to any specific patient’s care or treatment. The educational content on or available through this site does not constitute medical advice from a physician and is not to be used as a substitute for treatment or advice from a practicing physician or other healthcare provider. Sepsis Alliance recommends users consult their physician or healthcare provider regarding any questions about whether the information on or available through this site might apply to their individual treatment or care.

Available Credit

  • 1.00 Participation
  • 1.30 RN CE Contact Hours
    Provider approved by the California Board of Registered Nursing, Provider Number CEP17068.
Please login or register to take this course.

 

This activity includes:

  • Pre-test
  • Pre-recorded webinar
  • Post-test
  • Evaluation

All components must be completed to earn a certificate of attendance. This course can be completed at your convenience.