CDI data search

sara.filas@aspirus.orgsara.filas@aspirus.org
in CDI Talk Archive
Hello, I am looking for some data and hoping someone out there may know of some. Is anyone familiar with a white paper or any information on the impact capture of CC's or MCC's could have if the chart you are reviewing already has this captured? What impact a 2nd CC could have?

Any information is much appreciated
thank you

Sara Filas BSN RN
Clinical Documentation Specialist
sara.filas@aspirus.org

Comments

  • jschoonhovenjschoonhoven
    edited April 2016
    I believe improved mortality data is the major benefit of adding additional cc's, mcc's and certain other diagnoses. If you have access to APR DRG software it is extremely useful for calculating the benefit of 'severity' queries.

    Janice Schoonhoven RN, MSN, CCDS
    Clinical Documentation Integrity
    Manager- PeaceHealth Oregon West Network
  • annnd2009@gmail.comannnd2009@gmail.com
    Are you asking what is the value of the second cc or second mcc?

    I would say (though there may be other reasons) the value of a second cc in and of it self it to have a back up if the first one is taken away/debated by auditors) BUT it can also impact SOI/ ROM scores which can be seen in the grouper/encoder. BUT sometimes they don
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    I don’t have any 'data' on it but the benefit is improved SOI/ROM and RAC/Denial prevention (charts with a single CC/MCC that impacts the DRG are targets).

    If you want to see the impact on SOI/ROM, you can do that with your encoder if it has APR information. In 3M you can actually pull a document that shows you which diagnoses impact the SOI/ROM.

    Not sure if I am answering your question....

    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
  • cmorellcmorell
    edited April 2016
    Just google "Impact Coding Paul Evans". You all know our guru, CDI Manager and coder extraordinaire and CDI talk contributor as well as ACDIS presenter..yes, I am a huge fan! A whole power point that you can use to illustrate to your physicians what's in it for them. I found it when a CMO asked me how patients with Severe Sepsis could have a higher SOI than patients with Severe Sepsis and Septic Shock? The answer may surprise you=it's true!

    Sorry it was too big to attach.

    [PPT] Impact of Coding on Metrics - Surviving Sepsis Campaign
    www.survivingsepsis.org/SiteCollectionDocuments/ImpactCoding.ppt‎CachedSimilar

    Sepsis – Impact of Coding upon Metrics ... Paul Evans, RHIA, CCS, CCS-P,
    CCDS ... 3rd parties use coded data for reimbursement, audits and compliance ...


    Charlie Morell
    HCA WFD CDI Manager
    Tampa FL
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    Thank you, "Charlie', you are too kind.

    Paul

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.412.9421

    evanspx@sutterhealth.org
  • sara.filas@aspirus.orgsara.filas@aspirus.org
    Thank you all this is most helpful! I appreciate the fast replies.
    Sara
  • don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
    edited April 2016
    One other thing to add -- there is increasing moves toward risk adjustment methodologies being included in reimbursement rates. CMS will start (in part) adjusting OUTPATIENT (ie, physician office payments) in January with group practices >100 providers (not just physicians) and a year later for >10 with a VBP system that includes both PQRS measures as well as an HCC based risk adjustment.

    I also have a vague recollection (but can't say for certain) that there will be risk adjusted involvement with readmisions.

    In any case, the more complete and specific documentation (and coding -- codes need to be reported), in general the better looking in terms of ROM, SOI, risk adjustment methodologies, etc.

    Don

    Donald A. Butler, RN, BSN
    Manager, Clinical Documentation Advisor Program
    Vidant Health, Greenville NC
    DButler@vidanthealth.com ( mailto:mDButler@vidanthealth.com )
  • sbainesbaine
    You can also get information from Dr Kennedy-he lectures on the importance of going beyond the MCC/CC hunt. An illustration of his was the improvement of SOI/ROM just by capturing PVD.


    There is a wealth of information regarding protecting your healthcare systems outlook with appropriately documented and captured SOI/ROM. Check out a presentation I co-authored for ACDIS 2014 conference on "why is my healthy patient dead in the bed". It has information that is helpful as well.

    Also, like some earlier said-google the search. there is plenty of information out there.

    Sara Baine, MSN-Ed, CCDS
    MedpartnersHIM, a P2P Staffing Company
    sbaine-c@medpartnershim.com
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