Sepsis remains one of the most challenging and high-risk areas in inpatient coding. Inconsistent provider documentation, varying interpretations of the Official Coding Guidelines, and disconnects between CDI, coding, and quality teams often lead to confusion when assigning principal diagnoses, particularly when determining the relationship between infection and organ dysfunction. Even more, a lack of standardized education and escalation pathways results in inconsistent coding decisions across cases and teams. These inconsistencies can lead to costly denials, audit vulnerability, rework, and downstream impacts to mortality, SOI, ROM, and quality metrics. Even experienced coders are left second-guessing their decisions.

The session also addresses how to navigate situations where payer criteria conflict with Official Coding Guidelines, reinforcing defensible, compliant coding decisions.

In this webcast, Payal Sinha, MBA, RHIA, CCDS, CDIP, CCS, CCS-P, CCDS-O, CRC, CRCR, will break down the complexities of sepsis, severe sepsis, and septic shock sequencing with clear, guideline-based strategies. Through case examples, decision trees, and practical tools, Payal will help you apply coding guidelines with confidence, align documentation across teams, and strengthen your audit defensibility. This session is designed for coders, CDI specialists, and revenue integrity professionals looking to standardize their approach and reduce variability in sepsis coding. The session also addresses how to navigate situations where payer criteria conflict with Official Coding Guidelines, reinforcing defensible, compliant coding decisions.

Why This is Relevant:

As payer audit intensity rises and clinical definitions for sepsis continue to evolve, organizations face growing exposure to denials and data inaccuracies. Even small inconsistencies in sequencing sepsis versus a localized infection can trigger denials, costly appeals, distort SOI/ROM scores, and impact public reporting tied to reimbursement and outcomes. Now is the time to standardize your team’s approach and reinforce documentation accuracy. Strengthening sepsis sequencing practices today not only reduces audit and denial risk, it also ensures defensible coding decisions, supports accurate public reporting, and enhances confidence across coding, CDI, and quality teams.

Learning Objectives:

• Apply Official Coding Guidelines to accurately sequence sepsis, severe sepsis, septic shock, and localized infections.
• Distinguish clinical indicators that support sepsis versus localized infection and clarify when organ dysfunction supports a sepsis diagnosis
• Correctly assign Present on Admission (POA) indicators in complex scenarios
• Identify documentation gaps and develop compliant, effective CDI queries
• Use standardized decision tools to reduce variability and strengthen audit defensibility

Who Should Attend:

Inpatient coders and auditors, CDI specialists and CDI leadership, Revenue integrity and denial prevention teams, Quality and clinical analytics teams, Physician advisors and providers