These coding job aids are the ICD-9-CM diagnosis codes from Attachments A, B, and C sorted numerically or alphabetically. LOOK for new codes effective on and after January 1, 2010.

• Coding Job Aids - Numerical  Posted December 11, 2009

• Coding Job Aids - Alphabetical  Posted December 11, 2009

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Definitions and FAQs

This document provides general explanations of common terms and questions about the utilization review process.

• Definitions (.pdf) added 3/2008

• FAQs (.pdf) revised 03/2009

• Concurrent Review and Quality Screening Process added 5/2008

• Admission/Continued Stay Review Process  updated 05/2008

• Retrospective Review Prepayment Review Process updated 05/2008

• Retrospective Post-payment Review Process updated 05/2008

• Appeals Reconsideration and Reassessment Process  updated 5/2008

• Quality Improvement Plan Process updated 12/2008

• Mandatory Concurrent Review Billing and Exception Process Flowcharts  updated 12/2008

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General Education Presentations

• Missing Vitals: Important Information for Utilization Review (pdf) added 12/4/2009
  A look at the importance of accurate and complete clinical summary for utilization review. Information necessary for admission, concurrent and retrospective prepayment review are highlighted.

• HFS' Mandatory Concurrent Review Requirements and Billing (pdf) added 7/13/2009
  An overview of mandatory concurrent review requirements, the importance of the admitting diagnosis code and an overview of the billing process.

• Retrospective Review presentation slides (.pdf) added 7/30/2008
  An overview of the review process for pre- and post-payment review, explaining the various timeframes for processing and completing reviews and the information needed when submitting medical record copies.

• Provider Web Reports presentation slides (.pdf) added 3/24/2009
  An overview of HSI's Web Reports system. Includes information on system and user access, report categories and summarizes 24 provider-specific reports. 

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Admission Certification Review Request	Form	Instruction
Continued Stay Review Request	Form	Instruction
Psychiatric Admission Certification Review Request	Form	Instruction
Psychiatric Continued Stay Review Request	Form	Instruction
Reconsideration Request	Form	Instruction
DRG Change Reassessment Request	Form	Instruction

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Utilization Review Manual

A comprehensive guide for HFS' utilization review program.

• Utilization Review Manual  (.pdf )  Revised June 2009

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Web User Guides

These documents provide useful visual guides for participants using the Web Review System. Click here to register for the next training session.  

SPECIAL SECTION - ON THE WEB

• Entering Clinical Information (.pdf) Tips and tricks to entering clinical information on Web

• Checking Status Online (.pdf)  Two different ways to check the status of your review requests

• Adding Additional Information (.pdf) See how easy it is to add in additional information on the Web

• HSI On The Web (.pdf)  Get the latest tips for easy Web review submissions.

• Top 3 Web Reports (.pdf)  Get review information & status quickly with real-time Web reports.

Web Application Instructions - posted 4/28/2009	A helpful visual guide to uploading HSI's news Web application, ERICOM.
Summary of Provider Web Reports (.pdf)	A helpful visual guide of the report inquiry feature allowing hospitals to obtain real-time status of HSI reviews.
User Maintenance Guide (.pdf)	Resource guide for User Maintenance Module used by HSI Web Administrators.
Web User Guide (.pdf)  UPDATED JULY 2009	Complete resource guide on how to enter a Web review.
Web Review Screen Examples (.pdf)	View screen shots of the Web review submission process.
Web Review System Features (.pdf)	List of the latest features of Web Review System.

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