Hierarchical CDI: Risk adjustment focus helps influence patient care

by Katherine Rushlau

Providence St. Peter Hospital in Olympia, Washington, has had a successful inpatient CDI program for seven years. In spring 2014, the facility, which encompasses 32 clinics and two acute care hospitals, began discussing CDI in the ambulatory setting, says Lena Lizberg, BSN, CDI program manager. The team started by doing a comprehensive record review and audit, which showed that providers focused more on E/M coding than diagnosis coding, thus doing little to illustrate their patients’ disease burden, Lizberg says. “We felt that CDI specialists could be effective support for our ambulatory providers in capturing all reportable diagnoses,” she says. As Providence began documenting HCCs, they noticed a few specific opportunities for CDI staff to capture greater specificity.