Disagree with request for a query

dallend@einstein.edudallend@einstein.edu
in CDI Talk Archive
Has anyone HAD to query even though you could not justify the query in our own mind? You give the detailed information regarding why no query was done while the pt was in house but you are told to query post discharge.
I have to do it but I was just wondering how often it happens at other facilities.

Comments

  • twoodstwoods
    edited May 2016
    I do not query after DC. The HIM Dept coder does this. If in doubt I consult with my Director and if together there is no data to support QQ, I do not Q.

    Theresa Woods, RN, MSN
    Jennings American Legion Hospital
    1634 Elton Road
    Jennings, La 70546
    Phone: 337-616-7297
    Fax: 337-616-7096
    twoods@jalh.com


  • kshumpertkshumpert
    edited May 2016
    I have had this come up occasionally. I equate it to scenarios when I worked in surgery. Sometimes the scrub or myself wanted to do an extra count just to feel safe. Our coders have to maintain >90% accuracy. I can only imagine the pressure they are under. I will always have the surgery team mentality and I want them to feel comfortable at the end of the day. If it makes them sleep better, ok


  • dogdog
    Generally if I tell my boss and the coder that I don't think it's clinically supported, they will let it go. I only had one time where I was very close to telling the coder that if she wanted the query that badly, she could call the doctor herself, because I wasn't going to compromise my credibility for a query I couldn't support. Fortunately she finally backed down.

    I think it would be silly to order me to pursue a bogus query, because I would clearly not present it to the physician as a desirable outcome. So what are the odds that they'd go along with the query?

    Renee

    Linda Renee Brown, RN, CCRN, CCDS
    Clinical Documentation Specialist
    Arizona Heart Hospital
  • stacy.vaughnstacy.vaughn
    edited May 2016

    I do not query after DC either. The coder does this.

    Stacy Vaughn, RHIT, CCS
    Data Support Specialist/DRG Assurance
    Aurora Baycare Medical Center
    2845 Greenbrier Rd
    Green Bay, WI 54311
    Phone: (920) 288-8655
    Fax: (920) 288-3052




  • bea.smithbea.smith
    edited May 2016
    Well stated, after all it is their initials going on the claim and their
    tails chewed when an audit occurs and something isn't coded just right.
    It's hard to feel comfortable about coding much of anything these days
    with the RAC, the MIC and every other auditor on the trail. With the
    audits and the implementation of ICD-10 in the next couple of years,
    there's definitely going to be a lot of coders changing careers.

    Bea Smith, RHIT
    Clinical Documentation Specialist
    Cullman Regional Medical Center
    ph: 256-737-2926
    fax: 256-737-2714







  • cbarnescbarnes
    edited May 2016
    Our coders don't like it but they query after discharge. Sometimes they request we take a chart back to the M.D. and I will do so depending on the situation. If it is just a query for coder "comfort" we as a group feel like it's in the coders' hands @ that point.


  • fentona@bronsonhg.orgfentona@bronsonhg.org
    edited May 2016
    We have no post discharge query process. We have asked that the coders do queries if necessary post discharge, they have refused and their director is very supportive of that. We do not query after discharge.


  • lspryszaklspryszak
    I was shocked when I read your reply! How can a group of people refuse to do their job and be supported by their director?!

    I guess nothing should surprise me, but it always does...
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