Tip: Oregon QIO posts physician query policy
June 23, 2011
CDI Strategies - Volume 5, Issue 13
While the bulk of discussion regarding how to ethically and responsibly submit queries to physicians revolves around releases from the American Health Information Management Association (AHIMA) releases, don’t discount advice from other potential sources. For example, Acumentra Health, Oregon’s Medicare Quality Improvement Organization (QIO), offers a generic physician query policy that facilities can compare against AHIMA guidance and their own policies and procedures.
The Acumentra sample echoes many of the tenets of AHIMA’s various releases. It suggests that the query policy should apply to all queries and to any/all individuals involved in the query process. It also states that queries should be submitted when the “inpatient medical record has incomplete, inconsistent, unclear, or ambiguous documentation for assigning ICD-9-CM diagnoses or procedure codes.” The sample policy also states that Post-Its and sticky notes should not be used to submit physician queries.
Acumentra’s sample query policy also suggests methods to monitor the overall query process and delineates items for programs to track to ensure quality and consistency.