Q: I need help identifying the principal diagnosis for the following situation. The patient presented with shortness of breath and hypoxia, and had emergent dialysis which resolved his symptoms. However the patient’s international normalized ratio (INR) was sub therapeutic due...Read More »
Q: Our CDI department is developing clarification forms and I have voiced concern with some of the templates. For example, the anemia clarification lists many possible diagnoses including aplastic anemia. If the listed condition would not be clinically acceptable based on the clinical...Read More »
Q:I am the only CDI specialist in our 150-bed facility. I have held the position for three years, and am the first one to do so helping to build the position from the ground up. Being the only CDI, I am on several committees, responsible for continual physician...Read More »
Q: Our case-mix index (CMI) seems to be dropping and management is putting pressure on the CDI staff to bring it back up, but I have heard that CDI programs should not be analyzed based on the (CMI) alone. Do you have any tips or advice about how I should track the CMI and how our efforts affect...Read More »
Q: We recently had a case where the patient was admitted from the ED with pneumonia but the attending hospitalist diagnosed acute bronchitis because the chest x-ray did not show infiltrates or any of the verbiage indicating possible pneumonia.
Q: I was under the impression that headings on a query form are leading. Can you help me with this? I would use a heading but replace the (example: Acute Renal Failure) with the physician’s wording (ex: Renal insufficiency). Then paint the clinical picture with appropriate choices.Read More »
Q: Our CDI program is three years old and our administration still questions our productivity goals. Initially we set benchmarks at 90-95% coverage rate of Medicare/Managed Medicare; 20-25% query rate; 90% response rate and 80% agree rate. Since census varies, we also established goals of...Read More »
Editor’s Note: The following questions were submitted for the ACDIS quarterly conference call of February 14, 2013, and were answered by Donna Wilson, RHIA, CCS, CCDS, Robert Gold, MD, Sylvia Hoffman, RN, CCDS, CCDI, CDIP, and Donald Butler, RN, BSN, of the ACDIS...Read More »