Identifying Query Opportunities – Heart Failure, Anemia, Diabetes and Malnutrition

Identifying Query Opportunities – Heart Failure, Anemia, Diabetes and Malnutrition is an online, self-paced course built for coders who review clinical documentation and need to quickly spot when a query is appropriate. Designed for inpatient coding teams and documentation review workflows (and helpful for outpatient and profee coders who see these diagnoses on a regular basis), this course walks through common documentation gaps, clinical indicators, diagnostic criteria, and treatment clues that signal opportunities to clarify type, acuity, severity, or linkage for four high-impact conditions.

Through condition-focused lessons and case studies, learners strengthen documentation-to-code decision-making for heart failure (including systolic versus diastolic and acute versus chronic), anemia (including etiology and acuity), diabetes (including complication linkage), and malnutrition (including severity supported by ASPEN criteria). By the end of the course, coders will be better prepared to identify compliant query opportunities that support accurate reporting and reduce back-and-forth clarifications that slow down final coding.

Included Lessons:

• Introduction
• Heart Failure 
• Anemia
• Diabetes
• Malnutrition

Key Takeaways

• Stronger Recognition of Query Opportunities: Build confidence in identifying when documentation for heart failure, anemia, diabetes, and malnutrition lacks the specificity needed for accurate code assignment.
• Clear Understanding of Clinical Indicators: Learn how signs, symptoms, diagnostic criteria, and treatment patterns support queries for type, acuity, severity, and linkage.
• Improved Clinical Validation Awareness: Recognize situations where documented diagnoses are not clinically supported and may require further clarification or validation review.
• Better Diagnosis-Specific Decision-Making: Apply condition-specific knowledge to distinguish between acute and chronic presentations, related versus unrelated conditions, and reportable versus non-reportable diagnoses.
• Reduced Documentation Ambiguity: Identify common documentation gaps that lead to coder uncertainty and unnecessary back-and-forth queries.
• More Accurate and Defensible Coding: Support appropriate code assignment that reflects patient severity and resource use while remaining aligned with compliant query practices.

Benefits of Taking this Course

• Stronger Recognition of Query Opportunities
• Greater Confidence Identifying Clinical Support and Gaps
• Fewer Coding Delays Caused by Documentation Ambiguity
• Improved Documentation Clarity for High-Impact Diagnoses
• Better Alignment with Compliant Query Practices (AHIMA and ACDIS)
• Stronger Support for Accurate and Defensible Code Assignment

FAQs

About Our Medical Coding Courses

HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a flexible, online education platform designed for today’s coders. With a growing catalog of AHIMA and AAPC-approved coding courses, HIAlearn supports both beginners and experienced coders looking to build confidence, accuracy, and CEU credits.

Courses are available across various coding types including CPT, E/M, ICD-10-CM, and ICD-10-PCS, and are designed for multiple specialties including inpatient, outpatient, profee, and CDI.

To stay up to date, coders can explore our Coding Updates hub for the latest ICD-10-CM, ICD-10-PCS, CPT, and IPPS changes. HIAlearn also supports organizations with group discounts and scalable team access, promoting accuracy, compliance, and continuous professional development across departments.