Q&A: Coder mismatch values

Q: What is the coding mismatch percentage for your team? And, if you know, how frequently is CDI correct resulting in coding changes? We would like to evaluate if the volume of coding opportunities we experience is on par with other teams across the industry.

Response #1: Our goal is to match 70% or greater. Usually, we have a match rate of 75%–80% systemwide with the coders.

Response #2: CDI-coder match rate is 70% or above. My CDI team is matching around 80%.

Out of the 20% mismatch, we interact with coding around 10%–15% of the time and out of those interactions, CDI team is correct 80% or more.

I track these interactions, because it is additional revenue generated by CDI that is unrelated to queries.

Response #3: We achieve approximately 75% on our match rate each month. If we have a principal diagnosis or impacting PCS code change that is not related to a query, we place a “data query” within our computer-assisted coding system. The “query” does not leave our software and serves as a data element we can track to show the volume and impact of these changes. This process is managed by leadership to ensure it is not overused.

Editor’s note: This question was answered by members of the ACDIS CDI Leadership Council and originally appeared in the CDI Leadership Insider, the exclusive newsletter for Council members. For the purposes of this article, all Council member answers have been deidentified.