Myocardial Rule out

Good morning!
Currently we are having an issue with Chest Pain/Myocardial issues related to RULED OUT ect. We have been running into issues where our physicians, CNP's and PA's will document MI/STEMI/NSTEMI the ENTIRE way through the chart and then on the DC summary NOT say any of those diagnosis' AND not say RULED out either....the coders-coding from the entire chart will code the MI and there are a few fallouts related to the pt not truly having and MI.

Our AMI co-coordinator would like a query made up for MI ruled out ect. I see the one on the ACDIS website, but does anyone else have one that may be a bit less cluttered or friendly? We have been through the "education" with the docs on how and why the coders would code an MI and explained they cannot make the judgment that the pt DID NOT have one "after study" based on indicators, tests ect, but the docs would like to see query made so that a request can be made if the coders have any questions.... (currently our CDS only review Medicare-and we don't even get to see all those) ....ANYWAY...help of any kind would be appreciated.


Juli Bovard RN CCDS
Certified Clinical Documentation Specialist
Clinical Effectiveness/Clinical Quality
Rapid City Regional Hospital
719-4390 (work)
786-2677 (cell)
"No Limit to Better......"

"The difference between the right word and the almost right word is the difference between lightning and the lightning bug."- Samuel "Mark Twain" Clemens

Comments

  • I can attach a few documents we created regarding CP, ACS and AMI - one i=
    s an informational sheet we use to educate the MI, Core Measure team, CDI=
    team and Coders .

    The other is the actual query we use - these may not exactly fit your needs=
    , but could be modified.

    Paul Evans, RHIA, CCS, CCS-P, CCDS

    Manager, Regional Clinical Documentation & Coding Integrity
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell: 415.637.9002
    Fax: 415.600.1325
    Ofc: 415.600.3739
    evanspx@sutterhealth.org
  • edited May 2016
    As usual, Paul, you are very helpful and an asset to our CDI Talk group, ACDIS, and the CDI industry as a whole.

    Thanks so much!

    Mark



    Mark N. Dominesey, RN, BSN, MBA, CCDS, CDIP
    Clinical Documentation Excellence
    Sr. Clinical Documentation Improvement Specialist
    Sibley Memorial Hospital
    Information Technology
    5255 Loughboro Rd NW
    Washington DC, 20016-2695
    W: 202.660.6782
    F: 202.537.4477
    mdominesey@sibley.org
    [cid:image002.gif@01CDA6E6.275E1AE0]
    http://www.sibley.org
  • edited May 2016
    Thanks to all of you who help us newbies understand more. You are an
    asset to us for sure....



    Jamie Dugan RN
    Clinical Documentation Improvement Specialist
    Baptist Health System
    office:904-202-4345
    cellular: 904-237-7253
    Business Email-jamie.dugan@bmcjax.com
    cdis.icd10@bmcjax.com
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