Extended criteria (experimental).
This is the broader ten-condition engine, kept as a secondary area. It shows ICD-10-CM codes and illustrative grouping effects
for CDI staff. The primary surface is Before you sign (kidney, measurement only).
All extended pages.
Exact Dx: documentation worklist
Published clinical criteria, applied as versioned rules to 180 synthetic inpatient encounters. The tool looks both ways: it flags documentation that is less specific than the chart supports and documented diagnoses the criteria do not support. Rows are ranked by the absolute size of the change, so removing an unsupported code ranks the same as adding a supported one. Nothing changes in the record until a clinician answers a query.
206
Specificity gapChart supports a more specific diagnosis than documented.
93
Clinical validation gapDocumented diagnosis the criteria do not support.
57
Clinical judgement requiredBorderline or contested: the rule declines to conclude.
| # | Encounter · condition | Kind | Documented | Criteria support | Effect (illustrative, FY2026) | Priority | Status | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Luca Abernath · Hyponatraemia ENC-00004 · Hospital Medicine |
Specificity gap | not documented | Hyponatraemia (moderate) E87.1 |
— → CC MS-DRG 872 → 872 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 2 | Esme Kestrel · Acute blood loss anaemia ENC-00007 · Hospital Medicine |
Specificity gap | not documented | Acute blood loss anemia D62 |
— → CC MS-DRG 194 → 194 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 3 | Florian Thorne · Acute blood loss anaemia ENC-00020 · Cardiology |
Specificity gap | not documented | Acute blood loss anemia D62 |
— → CC MS-DRG 292 → 292 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 4 | Jalen Sallow · Heart failure ENC-00026 · Hospital Medicine |
Specificity gap | “CHF” I50.9 |
Chronic diastolic (HFpEF) heart failure I50.32 |
non-CC → CC MS-DRG 193 → 193 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 5 | Amara Yardley · Acute kidney injury ENC-00037 · Hospital Medicine |
Specificity gap | not documented | Acute kidney injury (KDIGO stage 2) N17.9 |
— → CC MS-DRG 194 → 194 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 6 | Nadia Larkspur · Acute kidney injury ENC-00040 · Cardiology |
Specificity gap | “acute renal insufficiency” N28.9 |
Acute kidney injury (KDIGO stage 1) N17.9 |
non-CC → CC MS-DRG 292 → 292 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 7 | Ines Nakashima · Hyponatraemia ENC-00041 · Hospital Medicine |
Specificity gap | not documented | Hyponatraemia (moderate) E87.1 |
— → CC MS-DRG 193 → 193 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 8 | Marisol Thorne · Acute kidney injury ENC-00042 · Hospital Medicine |
Specificity gap | not documented | Acute kidney injury (KDIGO stage 2) N17.9 |
— → CC MS-DRG 194 → 194 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 9 | Marisol Thorne · Malnutrition ENC-00042 · Hospital Medicine |
Specificity gap | not documented | Moderate (non-severe) protein-calorie malnutrition (acute illness context) E44.0 |
— → CC MS-DRG 194 → 194 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 10 | Kenji Galloway · Acute kidney injury ENC-00046 · Hospital Medicine |
Specificity gap | not documented | Acute kidney injury (KDIGO stage 1) N17.9 |
— → CC MS-DRG 689 → 689 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 11 | Jun Upfield · Acute blood loss anaemia ENC-00050 · Cardiology |
Specificity gap | “anemia” D64.9 |
Acute blood loss anemia D62 |
non-CC → CC MS-DRG 292 → 292 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 12 | Amara Merriweather · Acute kidney injury ENC-00053 · Pulmonology |
Specificity gap | “acute renal insufficiency” N28.9 |
Acute kidney injury (KDIGO stage 1) N17.9 |
non-CC → CC MS-DRG 190 → 190 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 13 | Yusuf Yardley · Acute blood loss anaemia ENC-00068 · Hospital Medicine |
Specificity gap | “anemia” D64.9 |
Acute blood loss anemia D62 |
non-CC → CC MS-DRG 377 → 377 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 14 | Hana Upfield · Acute blood loss anaemia ENC-00072 · Hospital Medicine |
Specificity gap | “anemia” D64.9 |
Acute blood loss anemia D62 |
non-CC → CC MS-DRG 194 → 194 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 15 | Camila Upfield · Heart failure ENC-00085 · Hospital Medicine |
Specificity gap | “HFrEF” I50.20 |
Acute systolic (HFrEF) heart failure I50.21 |
CC → MCC MS-DRG 871 → 871 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 16 | Pilar Kestrel · Chronic kidney disease ENC-00092 · Hospital Medicine |
Specificity gap | not documented | Chronic kidney disease stage 4 N18.4 |
— → CC MS-DRG 871 → 871 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 17 | Dario Fairbanks · Chronic kidney disease ENC-00093 · Hospital Medicine |
Specificity gap | “CKD” N18.9 |
Chronic kidney disease stage 4 N18.4 |
non-CC → CC MS-DRG 690 → 690 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 18 | Wes Hartwell · Acute kidney injury ENC-00111 · Hospital Medicine |
Specificity gap | “worsening renal function” N28.9 |
Acute kidney injury (KDIGO stage 1) N17.9 |
non-CC → CC MS-DRG 193 → 193 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 19 | Bodhi Foxhall · Acute blood loss anaemia ENC-00122 · Hospital Medicine |
Specificity gap | “anemia” D64.9 |
Acute blood loss anemia D62 |
non-CC → CC MS-DRG 689 → 689 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 20 | Dmitri Marlow · Hyponatraemia ENC-00123 · Hospital Medicine |
Specificity gap | not documented | Hyponatraemia (profound) E87.1 |
— → CC MS-DRG 193 → 193 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 21 | Odette Brightwater · Acute blood loss anaemia ENC-00127 · Hospital Medicine |
Specificity gap | “anemia” D64.9 |
Acute blood loss anemia D62 |
non-CC → CC MS-DRG 871 → 871 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 22 | Tobias Ivers · Acute blood loss anaemia ENC-00129 · Cardiology |
Specificity gap | “anemia” D64.9 |
Acute blood loss anemia D62 |
non-CC → CC MS-DRG 292 → 292 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 23 | Nico Bellweather · Acute blood loss anaemia ENC-00130 · Hospital Medicine |
Specificity gap | not documented | Acute blood loss anemia D62 |
— → CC MS-DRG 193 → 193 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 24 | Quinn Yardley · Hyponatraemia ENC-00131 · Cardiology |
Specificity gap | not documented | Hyponatraemia (profound) E87.1 |
— → CC MS-DRG 291 → 291 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 25 | Florian Treadwell · Acute kidney injury ENC-00134 · Hospital Medicine |
Specificity gap | “renal insufficiency” N28.9 |
Acute kidney injury (KDIGO stage 2) N17.9 |
non-CC → CC MS-DRG 871 → 871 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 26 | Kenji Juniper · Heart failure ENC-00135 · Hospital Medicine |
Specificity gap | “diastolic heart failure” I50.30 |
Acute diastolic (HFpEF) heart failure I50.31 |
CC → MCC MS-DRG 689 → 689 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 27 | Esme Bellweather · Acute kidney injury ENC-00148 · Hospital Medicine |
Specificity gap | not documented | Acute kidney injury (KDIGO stage 1) N17.9 |
— → CC MS-DRG 193 → 193 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 28 | Ximena Pemberton · Acute blood loss anaemia ENC-00159 · Pulmonology |
Specificity gap | “anemia” D64.9 |
Acute blood loss anemia D62 |
non-CC → CC MS-DRG 190 → 190 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 29 | Nadia Greaves · Hyponatraemia ENC-00162 · Hospital Medicine |
Specificity gap | not documented | Hyponatraemia (mild) E87.1 |
— → CC MS-DRG 690 → 690 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 30 | Celeste Okafor · Acute kidney injury ENC-00172 · Hospital Medicine |
Specificity gap | “acute renal insufficiency” N28.9 |
Acute kidney injury (KDIGO stage 2) N17.9 |
non-CC → CC MS-DRG 690 → 690 (RW +0.0000) |
44
|
Open | |||||||||||||||
| 31 | Ximena Hartwell · Obesity ENC-00166 · Pulmonology In hospital: concurrent review Resident note awaiting attending cosign Model draft failed the query linter: edit before sending |
Specificity gap | not documented | Obesity, class 3 E66.813 |
— → non-CC MS-DRG 192 → 191 (RW +0.2010) |
42
|
Open | |||||||||||||||
| 32 | Teodora Vance · Chronic kidney disease ENC-00001 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | “CKD” N18.9 |
Chronic kidney disease stage 3b N18.32 |
non-CC → non-CC MS-DRG 193 → 193 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 33 | Marisol Okafor · Malnutrition ENC-00009 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | “malnourished” E46 |
Moderate (non-severe) protein-calorie malnutrition (chronic illness context) E44.0 |
CC → CC MS-DRG 378 → 378 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 34 | Rosalind Upfield · Pressure injury ENC-00018 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | “sacral decubitus ulcer” L89.159 |
Pressure injury of sacral region, unstageable L89.150 |
non-CC → non-CC MS-DRG 872 → 872 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 35 | Vera Quillan · Malnutrition ENC-00048 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | “malnutrition” E46 |
Moderate (non-severe) protein-calorie malnutrition (acute illness context) E44.0 |
CC → CC MS-DRG 690 → 690 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 36 | Luca Greaves · Heart failure ENC-00057 · Cardiology In hospital: concurrent review |
Specificity gap | “diastolic heart failure” I50.30 |
Acute on chronic diastolic (HFpEF) heart failure I50.33 |
principal → principal MS-DRG 292 → 292 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 37 | Mara Pemberton · Sepsis ENC-00061 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign Contested definitions (Sepsis-2 vs Sepsis-3) |
Specificity gap | “sepsis” A41.9 |
Sepsis with septic shock R65.21 |
principal → principal MS-DRG 871 → ? |
35
|
Open | |||||||||||||||
| 38 | Jun Galloway · Obesity ENC-00067 · Hospital Medicine In hospital: concurrent review Model draft failed the query linter: edit before sending |
Specificity gap | “obesity” E66.9 |
Obesity, class 3 E66.813 |
non-CC → non-CC MS-DRG 193 → 193 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 39 | Ximena Bellweather · Obesity ENC-00074 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign Model draft failed the query linter: edit before sending |
Specificity gap | “obesity” E66.9 |
Obesity, class 3 E66.813 |
non-CC → non-CC MS-DRG 871 → 871 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 40 | Celeste Ravensworth · Heart failure ENC-00077 · Cardiology In hospital: concurrent review |
Specificity gap | “systolic heart failure” I50.20 |
Acute on chronic systolic (HFrEF) heart failure I50.23 |
principal → principal MS-DRG 292 → 292 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 41 | Priya Nakashima · Chronic kidney disease ENC-00080 · Cardiology In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | not documented | Chronic kidney disease stage 3a N18.31 |
— → non-CC MS-DRG 291 → 291 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 42 | Priya Nakashima · Heart failure ENC-00080 · Cardiology In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | “chronic systolic heart failure” I50.22 |
Acute on chronic systolic (HFrEF) heart failure I50.23 |
principal → principal MS-DRG 291 → 291 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 43 | Lena Northam · Chronic kidney disease ENC-00087 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | “CKD” N18.9 |
Chronic kidney disease stage 3a N18.31 |
non-CC → non-CC MS-DRG 871 → 871 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 44 | Lena Northam · Obesity ENC-00087 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign Model draft failed the query linter: edit before sending |
Specificity gap | not documented | Obesity, class 3 E66.813 |
— → non-CC MS-DRG 871 → 871 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 45 | Celeste Marlow · Chronic kidney disease ENC-00101 · Hospital Medicine In hospital: concurrent review |
Specificity gap | “CKD stage 3” N18.30 |
Chronic kidney disease stage 3b N18.32 |
non-CC → non-CC MS-DRG 195 → 195 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 46 | Kenji Oyelaran · Obesity ENC-00103 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign Model draft failed the query linter: edit before sending |
Specificity gap | “obesity” E66.9 |
Obesity, class 3 E66.813 |
non-CC → non-CC MS-DRG 194 → 194 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 47 | Dmitri Greaves · Chronic kidney disease ENC-00106 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | not documented | Chronic kidney disease stage 3a N18.31 |
— → non-CC MS-DRG 689 → 689 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 48 | Dmitri Greaves · Malnutrition ENC-00106 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | “malnourished” E46 |
Moderate (non-severe) protein-calorie malnutrition (chronic illness context) E44.0 |
CC → CC MS-DRG 689 → 689 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 49 | Silas Dunmore · Chronic kidney disease ENC-00137 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign |
Specificity gap | “chronic kidney disease” N18.9 |
Chronic kidney disease stage 3b N18.32 |
non-CC → non-CC MS-DRG 193 → 193 (RW +0.0000) |
35
|
Open | |||||||||||||||
| 50 | Silas Dunmore · Obesity ENC-00137 · Hospital Medicine In hospital: concurrent review Resident note awaiting attending cosign Model draft failed the query linter: edit before sending |
Specificity gap | not documented | Obesity, class 3 E66.813 |
— → non-CC MS-DRG 193 → 193 (RW +0.0000) |
35
|
Open |
"Approved" in the status column means the query was sent; "Rejected" means a CDI specialist dismissed the finding with a reason. Grouping effects use a small embedded subset of public CMS FY2026 tables and are illustrative, never a payment estimate.