Sepsis Claims Denials: An Ounce of Prevention
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.
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!
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.
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.
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- 1.00 Participation
- 1.30 RN CE Contact HoursProvider approved by the California Board of Registered Nursing, Provider Number CEP17068.