Book excerpt: Using CDI to support coding accuracy
The CDI and coding teams should routinely meet to discuss documentation issues, physician/provider challenges, and DRG variations. Many organizations conduct DRG comparisons between the CDI and coding teams. DRG assignment is an excellent area for education for both teams.
To conduct DRG comparisons, an interface between the coding system and CDI system should be available, or the CDI worksheets should be available to the coders. This allows the coders to check their DRG against the DRG that the CDI specialist pursued. As differences are found between the DRG that CDI pursued and the DRG that was coded, the coder and CDI specialist can discuss the discharge documentation to determine which DRG is supported by that documentation. If they cannot agree, there is usually a mediation process that involves coding management and CDI management. If agreement cannot be achieved at this level, then an external consultant may be used.
Regardless, the goal of the comparison process is to facilitate education of coding rules and regulations for the CDI professionals as well as a more thorough understanding of clinical processes for the coding specialists. The comparison process has been very advantageous in the post-ICD-10 era, because CDI professionals did not always receive the same in-depth ICD-10 education that the coding team did. As the ICD-10 coding rules continue to be refined, the educational process occurring during the DRG compare program is beneficial for CDI professionals. This is another benefit of having the two teams working within the same department. HIM Briefings’ 2017 coding productivity benchmarking survey indicated that nearly 75% of the respondents had a CDI program. More than 46% of the respondents that had a CDI program reported that coding and CDI were in the same department.
Editor’s note: This article is an excerpt from The Contemporary Guide to Health Information Management.