tracking revenue impact

katysuegood@gmail.comkatysuegood@gmail.com
edited April 2016 in CDI Talk Archive
Sorry, I have another question...

Do you currently retrospectively track whether the CDI themselves impacted a record with a query? IE: does the CDI retrospectively look at the coded record to determine whether a diagnosis that was queried for later became the SOLE CC/MCC or PDX that impacted the DRG assignment and then track this for revenue impact for the CDI program?

Thanks!

Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404

Comments

  • vanessa.falkoffvanessa.falkoff
    edited April 2016
    Yes I do quarterly report of this info:

    Query Date

    Account #

    Topic

    Physician

    Results

    Pre Query DRG

    RW

    LOS

    Post Query DRG

    RW

    LOS

    LOS days Gained

    RW Gain

    Increased payment

    PAYOR


    I will send you the spread sheet with the formulas if you like :)
    Vanessa Falkoff RN
    Clinical Documentation Coordinator
    University Medical Center of Southern Nevada
    1800 W Charleston Blvd
    Las Vegas, NV
    vanessa.falkoff@umcsn.com
    office 702-383-7322

    Compassion * Accountability * Respect * Integrity
  • Unknown
    edited April 2016
    We track if the query impacted:

    1. Reimbursement (1st cc/mcc)

    2. Increase of SOI/ROM

    3. 2nd cc or 2nd mcc (audit mitigation)

    4. Integrity ( for the good of record, education, research and humanity:))
    It is arduous but my team validates each and every query placed by a CDS for this impact and we report out on it.

    Thank you,

    Jane Hoyt, BA, BSN, RN, CCDS, CDIP, CPC-H I Director I Clinical Documentation Integrity I SCL Health I Systems &Technology Service Center- HIM Division I 12600 W. Colfax Ave Suite A-270 Lakewood, CO 80215 I 303-603-9581 I jane.hoyt@sclhs.net
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    So the CDI's basically look at the final coding summery, back the queried dx out of it and put it back in to see if it had impact on SOI/ROM as well as the CC/MCC impact and audit risk mitigation? How much has this impacted productivity? How many patients do your CDI's review daily?

    Also, for those that do this, do you review all payers and if so what do you do for non-DRG payors?

    Vanessa, I would love to see the spreadsheet!

    Thank you!!

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
  • draperjdraperj
    edited April 2016
    Vanessa , also interested could you send to me too?
  • kerryseekircherkerryseekircher
    edited April 2016
    Hi Jane-
    That is excellent and valuable information to report out on your program. I have heard of programs tracking the rate of second cc/mcc capture and have thought about doing that here-in addition to following the drg denial rate to see if there is a downward trend over time.
    We currently report out an estimated variance when obtaining the 1st cc/mcc or change the pdx. In addition, we review 100% of mortalities-on this population, we report the pre/post rw, pre/post soi/rom, and pre/post payment variance as well as track the # of queries to the md/coding for the palliative care code.
    For compliance purposes, we also keep a separate report in MIDAS to show cases where we have advised a change (mostly coding changes) which decreases the payment.
    Katie-we do reconcile all of our cases and verify the impact of our queries. We also have found that sometimes things get missed and by reconciling, we can make sure that the cc's and mcc's are being coded. If we ask coding to add a missed cc/mcc or change a pdx, we also track this info in our monthly financial report.
    Thanks,
    Kerry


    Kerry Seekircher, RN, BS, CCDS, CDIP
    Documentation Specialist Supervisor
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013
  • vanessa.falkoffvanessa.falkoff
    edited April 2016
    Yes but you didn't include your email :)

    Vanessa Falkoff RN
    Clinical Documentation Coordinator
    University Medical Center of Southern Nevada
    1800 W Charleston Blvd
    Las Vegas, NV
    vanessa.falkoff@umcsn.com
    office 702-383-7322

    Compassion * Accountability * Respect * Integrity
  • Unknown
    edited April 2016
    Vanessa, could I be included as well? Thanks!

    Elaine Sakala RN
    Clinical Documentation Specialist/UR
    Delta County Memorial Hospital
    esakala@deltahospital.org
    970-874-2287
  • draperjdraperj
    edited April 2016
    Vanessa sorry thought it was there, here it is. Thanks

    Julie Draper
    CDI Team Lead
    Mercy Medical Center North Iowa
    draperj@mercyhealth.com
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