Chest Pain Queries

Unknown

I am new to the CDI talk forums and I wanted to ask about chest pain queries and how you calculate potential loss? For example, you query for the underlying cause of the patient's chest pain and the physician's final diagnosis ends up being "chest pain". Of the many potential diagnosis possibilities including GERD, Angina, how do you drill down for the potential loss? Even though you have the physician's diagnosis, the many possibilities make it difficult to determine what you could have potentially recovered given a more definitive diagnosis. Any suggestions or input? Thanks

Unknown

We've been doing our CDI program for three years and chest pain is still
the number 1 diagnosis at our hospital. Being a teaching facility with
frequent resident turnover, it's hard to educate everyone. Many chest
pain queries go unanswered, and attendings are not held accountable,
therefore, it's difficult to correct the problem. I do monthly training
and drill it into everyone, including doing a newsletter for physicians
discussing the topic. Buy in is difficult, let me know if you conquer
it, because I certainly haven't!


Stacey Forgensi, RN, CCRN, CCDS
Clinical Documentation Specialist
Erie County Medical Center
sforgens@ecmc.edu
Pager 642-1011

Unknown

My facility has another problem developing with chest pain. Our one day stay CP were always made OBV, but now a Physician Review company that reviews for medical necessity is making the majority of the cases inpatient status. Now our number of MS DRG 313 are rising and our physicians love to document atypical chest pain or cause undetermined. But because the medical necessity will pass for RACs, there doesn't to be as much concern that physicians need more education on documentation. The whole focus seems to be on RAC reviews.

Christina Raad RN
Clinical Documentation Specialist
Central DuPage Hospital
630 933 4193
pager 630 255 1164

Unknown

"atypical chest pain" is a big problem at my hospital too.


Stacey Forgensi, RN, CCRN, CCDS
Clinical Documentation Specialist
Erie County Medical Center
sforgens@ecmc.edu
Pager 642-1011

digardsk

When we have a generic "chest pain", we ask for more specificity or underlying cause. We often get a response. The financial impact can be tracked in our software if the DRG does change.

Kim

tiffany_susan

Does this pass with RAC? We EHR that determines patient status, and have
had the same situation .... patients are admitted that normally would be
OBS and our capture rate has dropped because they are one day length of
stays, DRG 313 is increasing ......... our consultants would like us to
focus on this DRG ......... it is very frustrating!

Thank you,
Susan Tiffany RN, CDS
Supervisor
Clinical Documentation Program
Robert Packer Hospital & Corning Hospital
570-882-6094 pager 465
Fax 570-882-6768
Tiffany_Susan@guthrie.org