Matthew K. Turner, MD, CCDS

Roseville, Minnesota
Matthew K. Turner, MD, CCDS Expert Witness
Curriculum Vitae

Clinical Validation & DRG

Contact this Expert Witness

  • Company: TCD Consulting, LLC
  • Phone: 714-580-9193
  • Cell: 714-580-9193

Specialties & Experience of this Expert Witness

General Specialties:

Hospitalist and Medical Coding

Keywords/Search Terms:

clinical validation, DRG validation, inpatient versus observation, hospital reimbursement, physician advisor, CDI, diagnosis denial, documentation adequacy, utilization management, auditor denials, AKI, malnutrition, acute respiratory failure, encephalopathy, sepsis, CDI query compliance, level of care, DRG reassignment

Education:

MD, Northwestern University Feinberg School of Medicine; Chief Resident, Internal Medicine, University of Minnesota / Minneapolis VA Medical Center; Residency, Internal Medicine, University of Minnesota; BS, University of St. Thomas (St. Paul, MN)

Years in Practice:

9

Additional Information

Matthew K. Turner, MD, CCDS is a board-certified internal medicine physician, actively practicing hospitalist, and physician advisor who serves as system medical director for clinical documentation integrity (CDI) in a large integrated health system. His work centers on clinical validation, DRG validation, documentation adequacy, level-of-care determinations, and payer or auditor disputes involving hospital reimbursement. Since 2020, Dr. Turner’s work has included both CDI and utilization management physician-level review. In his CDI leadership roles, he has performed more than 500 physician-level clinical validation reviews involving provider-disputed queries, escalations, and prospective query appropriateness consultations; reviewed more than 100 auditor-initiated diagnosis denials since 2022 in which denial of a specific diagnosis typically resulted in DRG reassignment and reduced reimbursement; and prepared written clinical justifications and participated in peer-to-peer discussions with payer and auditor medical directors regarding the clinical validity of denied diagnoses. In his utilization management physician advisor role, he has reviewed more than 10,000 cases for level-of-care determinations, conducted more than 500 peer-to-peer discussions with payer medical directors, and prepared written appeals and clinical analyses supporting contested admission and level-of-care determinations. Dr. Turner maintains active clinical, CDI leadership, and physician advisor roles simultaneously, bringing a current, practice-based perspective to medical record review and case analysis. He is certified by the American Board of Internal Medicine and holds the Certified Clinical Documentation Specialist (CCDS) credential. Areas of engagement include clinical validation of principal and secondary diagnoses, DRG assignment and DRG validation, documentation adequacy, CDI query practice, level-of-care determinations, payer denials, auditor denials, and reimbursement-related chart review.