A Note from the Instructors: The essence of CDI
by Laurie Prescott, RN- MSN, CCDS, CDIP
I recently celebrated my third anniversary working for ACDIS and HCPro. We are currently training a new instructor, and that has made me a bit reminiscent of my last few years and my career in CDI. I honestly think this is the best job in the world—I get to meet such interesting people and have found, on the whole, those who enter the profession are forward thinkers, smart, innovative, and up for a challenge. These qualities are necessary in this field because our world is forever changing.
When I started with HCPro, the focus of CDI was ICD-10 CM/PCS implementation. We were learning the new code set and trying to understand the procedural coding system. I remember cautioning Boot Camp attendees that the big changes would not necessarily occur with the transition to the new code set, but in the following years as CMS began to adjust the values of specific codes and mappings. We knew there would likely be changes to the Official Guidelines of Coding and Reporting, AHA’s Coding Clinic advice and DRG assignments. The effect of these changes are now being seen, and my bet is next year will provide even more challenges.
Many of the changes are significant, including the meaning of the word “with” within the tabular list and no longer needing linkage documentation by the provider—we can now differentiate the type of heart failure from the provider’s shorthand related to the ejection fraction. We have been introduced to new clinical definitions, such as Sepsis 3 and the National Pressure Ulcer Advisory Panel differentiation of pressure injury. Likely the biggest changes are related to how we are now reimbursed under Hospital Value Based Purchasing, bundled payments, and risk adjustment, to name a few.
It is easy to get overwhelmed by change. It is easy to put your head in the sand and not learn how these changes affect you and your organization. And yet, as I said, we, as CDI professionals, demonstrate the ability to take on change, move forward, and lead others. That is what we do best. We would not be doing our jobs, nor doing our providers and patients any favors, by ignoring change.
I have a sign by my desk that has been leading me for more than 15 years. It is a quote by Eric Hoffer that states, “In times of change learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists.”
Take charge and inherit the earth. Stay informed, educate others, and be a leader. That is the essence of CDI!
Editor’s Note: Laurie L. Prescott, RN, MSN, CCDS, CDIP, AHIMA Approved ICD-10-CM/PCS Trainer, is the CDI Education Director at HCPro in Danvers, Massachusetts. Contact her at lprescott@hcpro.com. For information regarding CDI Boot Camps visit http://hcmarketplace.com/clinical-doc-improvement-boot-camp-1.