Journal excerpt: Extending CDI’s reach

By Janie L. Brown, RN

CDI came on the healthcare scene relatively recently, and at its inception, reimbursement was king—the principal aim of such programs was to capture additional money by moving the CC/MCC and CMI needle. It’s readily apparent that CDI can increase reimbursement on individual patient records. When we drive the CMI higher, we can also see reimbursement rise on entire patient populations. It’s even easy to see that a query for present on admission status on a urinary tract infection or pneumonia can keep you from getting dinged for a hospital-acquired condition and boost quality scores for your hospital. Obtaining that MCC on the record was how many of us were trained to function in our role, moving on to the next record once the maximum DRG was obtained.

The evolution of our role occurred at lightning speed, though, and our influence now reaches beyond reimbursement. As the value of highly trained individuals performing concurrent chart review became apparent, many departments began to reach out to CDI staff to tap our clinical and coding knowledge. As CDI specialists, we’re charged with obtaining the most accurate and specific diagnoses on each patient record. We all understand that this is the right thing to do for a myriad of reasons.

Just about everything we do in CDI affects some other area of the organization—quality, case management, revenue cycle, and even patient care. CDI outcomes should be considered and intentional. For me, one of the most gratifying parts about the CDI role is using all the knowledge and experience I’ve gained through years spent at the bedside to positively influence the financial wellbeing of our healthcare organizations.

Editor’s note: This is an excerpt of an article from the September/October issue of the CDI Journal. To read the full article, click here. To read the entire issue, click here.