Coders and clinicians seem to speak different languages. CDI specialists often serve as the translators between clinicians and coders, so it's important that all three groups work together.
Both coders and CDI specialists can query physicians when documentation:
Third-party regulatory agencies often question the clinical validity of a physician’s diagnosis. Most hospitals have had a Recovery Auditor deny a claim due to lack of documentation identifying supportive clinical indicators in the medical record. But until recently, CDI specialists and coders...Read More »
Let’s face it: CDI is a large and growing profession in part because it increases hospital case-mix indexes and reimbursement. A good CDI program leads to accurate documentation of specific diagnoses, resulting in a more accurate representation of a patient’s severity of illness, and better...Read More »
Timothy N. Brundage, MD, CCDS, is a diplomate of the American Board of Internal Medicine and the principal of Brundage Medical Group, LLC (BMG). He has been a member of the ACDIS Advisory Board since 2011. He and his wife, Patty (a nurse practitioner who helps with CDI efforts of BMG), are...Read More »
On January 15, UnitedHealth Group Inc. and Mayo Clinic announced a new joint venture dubbed Optum Labs focused on joining data streams and handing them to researches to investigate how to improve healthcare and lower costs,...Read More »
The American Hospital Association (AHA) released two fact sheets this month highlighting the plight of inadequate hospital reimbursements by the government. In one, the AHA states that Medicare and Medicaid underpaid...Read More »
What is the goal of a CDI program? Most of the ones I see still focus on DRG optimization. We need to make the physicians allies of our CDI programs, and right now they are not. Instead, they are often targets of our queries. So how do you make the transition? By changing physician behavior one...Read More »
