Meet a Member: Learning CDI is like learning a new language, but well worth it
Ellen Jantzer, RN, MSN, CCDS, CRC, CCS, is the CDI manager at Asante in Medford, Oregon, and she is a member of the Northwest ACDIS local chapter.
ACDIS: How long have you been in the CDI field? What did you do before entering CDI?
Jantzer: I have been in the CDI field since 2012. At the time, I was hired to be the coordinator for the CDI program as it was undergoing a change of leadership. The team had moved from performance improvement to revenue integrity which was causing a lot of angst and uncertainty. Shortly after that, the team moved again to become our own department reporting to the chief quality officer. This put me in the position of being a new CDI specialist tasked with rebuilding and restructuring the entire team.
As a nurse, my time in the float pool offered a wide variety of clinical exposure, but not a lot of depth in any one area. After about eight years of patient care, I took a job in resource management working mostly in utilization review. That role morphed into being a clinical auditor first in revenue management and later in revenue integrity. As it turns out, my familiarity with multiple areas of the hospital has benefited me as a CDI specialist.
ACDIS: Why did you get into this line of work?
Jantzer: My director asked if I would be willing to become the CDI coordinator and I agreed without having the slightest idea of what that was. I trusted my boss and if she needed help in this area and believed I could do it, then I was willing to try. I remember sitting my office wondering what I had agreed to! I knew I had to learn a lot and I had to learn it fast; the ACDIS website became my “best friend and colleague.”
ACDIS: What has been your biggest challenge?
Jantzer: Understanding the coding! I don’t know how many times I would come up with a “great idea” that I would present to the coder. She would wait patiently for my lengthy clinical explanation before saying “well, there’s this Coding Clinic….” Now that I have earned two coding certifications, there is sense of irony when I hear myself echo these same words to others.
ACDIS: What has been your biggest reward?
Jantzer: My biggest reward has been seeing the changes I worked to implement happen. I sit in meetings and talk to physician leaders who argue against everything I say. Then later, it amazes me to hear those same providers speak my exact words to affect change amongst their peers.
ACDIS: How has the field changed since you began working in CDI?
Jantzer: When I first started in CDI, we were in ICD-9, the medical record was a paper chart, and we did not have CDI software tools—it was the dark ages of CDI! Along with those changes, our focus has shifted from predominately CC/MCC capture to overall accuracy of the documentation as it relates to ICD-10 coding. At my organization, we have seen tremendous growth in the size and scope of CDI with responsibilities for inpatient and outpatient areas.
ACDIS: Can you mention a few of the “gold nuggets” of information you’ve received from colleagues on The Forum or through ACDIS?
Jantzer: Networking with other CDI professionals has been my lifeline. We are in such a unique profession where no one outside of CDI seems to understand what we do—not the doctors we query, not the C-suite who approves our program. Being able to talk to CDI teams outside our organization helps ensure that our practice is the best it can be.
The best advice I ever got was to not become “encoder dependent.” I tell my new hires that using the encoder before you understand the coding rules can get you into trouble; it’s akin to using a calculator before you understand math. You can punch in numbers and get an answer back but that doesn’t guarantee the answer is correct.
ACDIS: If you have attended, how many ACDIS conferences have you been to? What are your favorite memories?
Jantzer: When I was first hired, I attended the national conference in San Diego. I have also attended the past three ACDIS Outpatient Symposiums and frequently attend local chapter events.
ACDIS: What piece of advice would you offer to a new CDI specialist?
Jantzer: The learning curve is STEEP! CDI is a new language (well, maybe three new languages: clinical, coding, and regulatory). It takes a long time to gain the knowledge you need to be successful so plan on investing both energy and time.
ACDIS: If you could have any other job, what would it be?
Jantzer: Right now, I love my job in CDI, so it is hard to imagine doing something else. On bad days, I think about leaving it all behind to travel with my husband in our van. I have this dream that I could work remotely from a beach or a mountain top. Or travel to various cities where I can work on a laptop while hanging out at a local bakery or coffee shop.
ACDIS: What was your first job?
Jantzer: Between semesters at college, I worked at a very small hospital. Since I was studying to be a nurse, everyone took it upon themselves to mentor me. I learned so much about life during this time and owe much of my success to the support this experience provided me.
ACDIS: Can you tell us about a few of your favorite things?
Jantzer: My husband tends to take on projects. Currently we are working to convert a Chevy van into a “stealth camper”—a van that looks like a passenger van from the outside but is a camper on the inside. Last year, we bought a house at auction which we are working to remodel and possibly rent as an Airbnb.
Living in Oregon, I spend a lot of time outdoors—hiking, river-rafting, and camping are my favorites. In the spring, you can find me hitting the local yard sales looking for items to match my husband’s current projects.
ACDIS: Tell us about your family and how you like to spend your time away from CDI (if you wish).
Jantzer: My husband, Jason, and I have been married for 34 years. We have four adult children and three granddaughters. We are blessed to have them all living close by so visits with them are frequent and often impromptu.