CDI screening tools

Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again. I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share if they currently use one or have any ideas for one? Thanks!

Jamie Dugan RN, CCDS
Clinical Documentation Improvement Specialist
3563 Philips Highway, Suite #106
Jacksonville, Florida 32207
Office: 904-202-4345

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Comments

  • edited April 2016
    I'm not sure if you've seen the CDI Roadmap, but phase II contains the following information that be helpful.

    Here is the link to the Roadmap: http://www.hcpro.com/acdis/cdi_roadmap_phase2.cfm

    Here is a section of it that contains some assessment ideas and scenarios:

    * Hire new CDI staff, performing assessment of coding skills and level of clinical knowledge. See sample document "Assessment of new CDI specialists". Total number of FTEs will depend upon:
    * Payer types reviewed
    * Total discharges
    * Accessibility of medical record
    * Initial skill sets and core competencies of hired CDI staff
    * See sample document "Orientation checklist"


  • Jamie,
    I don't see your e-mail address in your signature.
    Can you e-mail me?

    I have a few exams that I saved from a previous post regarding this topic I can send to you.

    Best,
    Greta


    Greta Goodman, CCDS
    Clinical Documentation Improvement Specialist
    Health Information Management
    Virginia Hospital Center
    1701 North George Mason Drive
    Arlington, VA 22205
    703-558-5336
    ggoodman@virginiahospitalcenter.com


    [CCDS_pin_1inch]



  • edited April 2016
    I also have some info Jamie


    Deanne Wilk, BSN, RN, CCDS, CCS
    AHIMA approved ICD-10-CM/PCS Trainer

    Clinical Documentation Improvement and Inpatient Coding Manager
    HIMS Department
    Good Samaritan Health System
    4th & Walnut Sts
    Lebanon, PA 17042
    dwilk@gshleb.org

    Phone: 717-270-7582
    Cell: 717-580-1436



  • edited April 2016
    Does anyone have an example query for when the physician documents Type 2 in the record? And how is it being coded. Tx!
    Cindy Slavin RN, BSN, CCDS
    Manager Clinical Appeals and Data Integrity
    Botsford Hospital
    248-615-7103

  • edited April 2016
    Attached is a query we use when a pt has elevated troponins meeting criteria for Type 2 MI. It is my understanding that Type 2 MI codes to Acute MI as ICD9 does not differentiate between Type 1, Type 2, Type 3 etc...


    Julie Cruz RN, CDS
    Clinical Documentation Specialist
    St. Joseph Health
    Eureka, CA 95501

    Julie. Cruz-SJE@stjoe.org
    Wk: 707-445-8121 Ext. 7550
    Cell: 707-267-0973
    Fax: 707-269-3683

  • edited April 2016
    Would it code to a NStemi?
    I welcome feedback as to how your facility is coding Type 2
    Thank you so much!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:33 AM
    To: Cindy Slavin
    Subject: RE:[cdi_talk] CDI screening tools

    Attached is a query we use when a pt has elevated troponins meeting criteria for Type 2 MI. It is my understanding that Type 2 MI codes to Acute MI as ICD9 does not differentiate between Type 1, Type 2, Type 3 etc...


    Julie Cruz RN, CDS
    Clinical Documentation Specialist
    St. Joseph Health
    Eureka, CA 95501

  • edited April 2016
    Scenerio: Patient presents with Sepsis due to pneumonia, the pneumonia was caused the influenza A....
    Does Sepsis drive the DRG?

  • edited April 2016
    I'm not a coder....there are times the coder takes the Type 2 as PDX (which I don't necessarily agree with). Some physicians seem to use Type 2/NSTEMI interchangeably. When I run through the encoder, I take it to "other specified".
    Perhaps the coders out there can offer more insight.

    Julie Cruz RN, CDS
    Clinical Documentation Specialist
    St. Joseph Health
    Eureka, CA 95501

  • If a Type @ MI is clearly documented, it is coded as either an STMI or NSTMI, depending upon the specific statement in the record. Am MI due to demand/mismatch is an AMI. It has been stated by some on this site that some coders do not consider a Type II an MI; however, it is clear these are acute Myocardial Infarcts.


  • The Type II AMI can be the Principal Diagnosis, depending upon the circumstances of the admission, diagnostic workup, and therapy.

    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

  • edited April 2016
    Thank you!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:47 AM
    To: Cindy Slavin
    Subject: RE:[cdi_talk] CDI screening tools

    If a Type @ MI is clearly documented, it is coded as either an STMI or NSTMI, depending upon the specific statement in the record. Am MI due to demand/mismatch is an AMI. It has been stated by some on this site that some coders do not consider a Type II an MI; however, it is clear these are acute Myocardial Infarcts.


    [cid:image002.png@01D087EA.EB2B12B0]


    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

  • Demand/Mismatch does not code to acute MI. It has been recommended that a query be initiated. This can affect many metrics. The cardiologists are even divided on this issue. Some cardiologists in our facility will dictate that although troponins are elevated this is not a MI but a supply demand mismatch issue. Other physicians, dictate that it is a MI with supply/demand mismatch. We struggle with this in our facility.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [Description: CCDS_pin_1inch]
    "We are His hands". Isaiah 64:8

  • A type II MI due to 'whatever cause' does code to an acute AMI. An infarct is an infarct, regardless of the etiology.

    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

  • I would interested in seeing these as well.  My email is ckitterman@pmh-ok.org. Thank-you,Christina Kitterman 


    On Wednesday, May 6, 2015 9:13 AM, CDI Talk wrote:


    I also have some info Jamie     Deanne Wilk, BSN, RN, CCDS, CCS AHIMA approved ICD-10-CM/PCS Trainer   Clinical Documentation Improvement and Inpatient Coding Manager HIMS Department Good Samaritan Health System 4th & Walnut Sts Lebanon, PA 17042 dwilk@gshleb.org   Phone:  717-270-7582 Cell:  717-580-1436       From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:09 AM
    To: Wilk, Deanne L.
    Subject: RE:[cdi_talk] CDI screening tools   Jamie, I don’t see your e-mail address in your signature. Can you e-mail me?   I have a few exams that I saved from a previous post regarding this topic I can send to you.   Best, Greta     Greta Goodman, CCDS Clinical Documentation Improvement Specialist Health Information Management Virginia Hospital Center 1701 North George Mason Drive Arlington, VA 22205 703-558-5336 ggoodman@virginiahospitalcenter.com           From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:59 AM
    To: Goodman, Greta
    Subject: [cdi_talk] CDI screening tools   Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again.  I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share if they currently use one or have any ideas for one? Thanks!   Jamie Dugan RN, CCDS Clinical Documentation Improvement Specialist 3563 Philips Highway, Suite #106 Jacksonville, Florida  32207 Office: 904-202-4345   NOTICE: This message is confidential, intended for the named recipient(s) and may contain information that is (i) proprietary to the sender, and/or,(ii) privileged, confidential and/or otherwise exempt from disclosure under applicable Florida and federal law, including, but not limited to, privacy standards imposed pursuant to the federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Receipt by anyone other than the named recipient(s) is not a waiver of any applicable privilege. Thank you in advance for your compliance with this notice.                  --- CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.   You are receiving this message as a member of CDI Talk as: ggoodman@virginiahospitalcenter.com If you would like to be removed from CDI Talk, please send a blank email to leave-cdi_talk-12403641.651ab590aed3ab660e7b1e28bdf7052a@hcprotalk.com --- Copyright 2013 HCPro, Inc., 75 Sylvan Street, Danvers MA 01923   **********************************************************************************************************
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    I reviewed the most recent 3M brief this week and they clarify that a type =
    II MI is not an MI because there is no infarction (cell death). If not clar=
    ified, it will code to an MI but they recommend clarifying.

    I do not feel that I have enough clinical knowledge to make my own determin=
    ation fo the clinical situation but I figured I would pass it on....

    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

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 11:08 AM
    To: Kathryn Good
    Subject: RE:[cdi_talk] CDI screening tools

    A type II MI due to 'whatever cause' does code to an acute AMI. An infarc=
    t is an infarct, regardless of the etiology.

    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

    [cid:image001.jpg@01D087ED.A7D7EFD0]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:03 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Demand/Mismatch does not code to acute MI. It has been recommended that a =
    query be initiated. This can affect many metrics. The cardiologists are e=
    ven divided on this issue. Some cardiologists in our facility will dictate=
    that although troponins are elevated this is not a MI but a supply demand =
    mismatch issue. Other physicians, dictate that it is a MI with supply/dema=
    nd mismatch. We struggle with this in our facility.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [cid:image002.jpg@01D087ED.A7D7EFD0]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:54 AM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    Thank you!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:47 AM
    To: Cindy Slavin
    Subject: RE:[cdi_talk] CDI screening tools

    If a Type @ MI is clearly documented, it is coded as either an STMI or NSTM=
    I, depending upon the specific statement in the record. Am MI due to dem=
    and/mismatch is an AMI. It has been stated by some on this site that some =
    coders do not consider a Type II an MI; however, it is clear these are acut=
    e Myocardial Infarcts.


    [cid:image003.png@01D087ED.A7D7EFD0]


    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

    [cid:image001.jpg@01D087ED.A7D7EFD0]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 7:26 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Does anyone have an example query for when the physician documents Type 2 i=
    n the record? And how is it being coded. Tx!
    Cindy Slavin RN, BSN, CCDS
    Manager Clinical Appeals and Data Integrity
    Botsford Hospital
    248-615-7103

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:59 AM
    To: Cindy Slavin
    Subject: [cdi_talk] CDI screening tools

    Good morning everyone. I posted yesterday, but really not get any feedback.=
    So I am trying once again. I have seen on CDI talk previously some posts =
    regarding screening tools (exams) for CDI candidates. Would anyone be willi=
    ng to share if they currently use one or have any ideas for one? Thanks!

    Jamie Dugan RN, CCDS
    Clinical Documentation Improvement Specialist
    3563 Philips Highway, Suite #106
    Jacksonville, Florida 32207
    Office: 904-202-4345

    ________________________________
    NOTICE: This message is confidential, intended for the named recipient(s) a=
    nd may contain information that is (i) proprietary to the sender, and/or,(i=
    i) privileged, confidential and/or otherwise exempt from disclosure under a=
    pplicable Florida and federal law, including, but not limited to, privacy s=
    tandards imposed pursuant to the federal Health Insurance Portability and A=
    ccountability Act of 1996 ("HIPAA"). Receipt by anyone other than the named=
    recipient(s) is not a waiver of any applicable privilege. Thank you in adv=
    ance for your compliance with this notice.



    ---

    CDI Talk is offered for networking purposes. For official rules and regulat=
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    I reviewed the most recent 3M brief this week and they clarif=
    y that a type II MI is not an MI because there is no infarction (cell death=
    ). If not clarified, it will code to an MI but they recommend clarifying.

     

    I do not feel that I have enough clinical knowledge to make my own determi=
    nation fo the clinical situation but I figured I would pass it on….

     

    Katy Good, RN, BSN, CCDS, CCS

    Clinical Documentation Program Coordinator

    AHIMA Approved ICD-10CM/PCS Trainer

    Flagstaff Medical Center

    Kathryn.G=
    ood@nahealth.com

    Cell: 928.814.940=
    4

     

    From:=
    CDI=
    Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2=
    015 11:08 AM
    To: Kathryn Good
    Subject: RE:[cdi_talk] CD=
    I screening tools

     

    A type  II MI due to ‘whatever cause’ does code=
    to an acute AMI.  An infarct is an infarct, regardless of the etiolog=
    y.

     

    Paul Evans, RHIA, C=
    CS, CCS-P, CCDS

     

    Manager, Regional Cli=
    nical Documentation & Coding Integrity

    Sutte=
    r West Bay

    =
    633 Folsom St., 7th Floor,  Office 7-044

    San Francisco, CA  94107=

    Cell:  415.412.9421

     

    evanspx@sutterhealth.org

    =
     

    =

     

    F=
    rom: CDI Talk [mailto:cdi_talk=
    @hcprotalk.com
    ]
    Sent: Wednesday, May 06, 2015 10:03 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

     

    Demand/Mismatch does not =
    code to acute MI.  It has been recommended that a query be initiated.&=
    nbsp; This can affect many metrics.  The cardiologists are even divide=
    d on this issue.  Some cardiologists in our facility will dictate that=
    although troponins are elevated this is not a MI but a supply demand misma=
    tch issue.  Other physicians, dictate that it is a MI with supply/dema=
    nd mismatch.  We struggle with this in our facility.

     

    Syndi Hudson, RN, CCDS,CCM   =

    CHRISTUS Santa Rosa New Braunfels =
               

    CDI Specialist=

    cynthia.hudson@christushealth.org

    830-643-6116 (Office) &nbsp=
    ;            &n=
    bsp;           &nbsp=
    ;    

    830-643-5139 (Fax)        &nbsp=
    ;            &n=
    bsp;           &nbsp=
    ;       

     3D

    “We are His hands”.  Isaiah 64:8

     

    From: CDI Talk [mailto=
    :cdi_talk@hcprotalk.com
    ]
    Sent: Wednesday, May 06, 2015 9:54 =
    AM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI scree=
    ning tools

    &nbsp=
    ;

    Thank you!

    =
     

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com] Sent: Wednesday, May 06, 2015 10:47 AM
    To: Cindy Slavin=

    Subject: RE:[cdi_talk] CDI screening tools

    =

     

    =
    If a Type @ MI is clearly do=
    cumented, it is coded as either an STMI or NSTMI, depending upon the specif=
    ic statement in the record.    Am MI due to demand/mismatch =
    is an AMI.  It has been stated by some on this site that some coders d=
    o not consider a Type II an MI; however, it is clear these are acute Myocar=
    dial Infarcts.

     

     

     

    &nb=
    sp;

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

     

    Manager, Regional Clinical Documentation & C=
    oding Integrity

    Sutter West Bay

    633 Folsom St., 7th Floor,=
      Office 7-044

    San Francisco, CA  94107

    Cell:&nbs=
    p; 415.412.9421

     

    evanspx@sutterhealt=
    h.org

     

    3D

    =

    &n=
    bsp;

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com] Sent: Wednesday, May 06, 2015 7:26 AM
    To: Evans, Paul
    =
    Subject: RE:[cdi_talk] CDI screening tools

     

    Does anyone have an example query for when the ph=
    ysician documents Type 2 in the record? And how is it being coded. Tx!=

    Cindy S=
    lavin RN, BSN, CCDS

    Manager Clinical Appeals and Data Integrity

    Botsford Hospit=
    al

    =
    248-615-7103

     

    From: CDI Talk [mailto:cdi_talk@hcpro=
    talk.com
    ]
    Sent: Wednesday, May 06, 2015 9:59 AM
    To: Cindy Slavin
    Subject: [cdi_talk] CDI screening tools=

     

    Good morning everyone. I posted yesterday, but really not get =
    any feedback. So I am trying once again.  I have seen on CDI talk prev=
    iously some posts regarding screening tools (exams) for CDI candidates. Wou=
    ld anyone be willing to share if they currently use one or have any ideas f=
    or one? Thanks!

     

    Jamie Dugan RN, CCDS

    Clinical Documentation Improvement Specialist

    3563 Philips Highway, Suite #106=

    Jacksonville, Florida&nbs=
    p; 32207

    Office: 904-202-4=
    345

     

    NOTICE: This message is=
    confidential, intended for the named recipient(s) and may contain informat=
    ion that is (i) proprietary to the sender, and/or,(ii) privileged, confiden=
    tial and/or otherwise exempt from disclosure under applicable Florida and f=
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  • Type II MI is definitely an MI, since there is damage to the myocardium. Unless they've documented ST elevation, I take it to NSTEMI. However, I don't think a type II MI in most situations should be the principal diagnosis because the focus of the care should be on treating the underlying cause. Not to mention that type II MIs as PDx have been screwing us up on core measures because type IIs are generally unrelated to CAD, which is what core measures are designed to treat.

    Renee

    Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
    Director, Clinical Documentation
    Tanner Health System
  • 3M is not official advice - per 3rd Universal Definition, this is an MI.
    The Third Universal Definition of Myocardial Infarction: Clinical Insights and Implications
    Disclosure: Dr. Jneid has nothing to disclose.
    Pub Date: Saturday, Aug. 25, 2012
    Author: Hani Jneid, MD, FACC, FAHA, FSCAI
    Affiliation: Baylor College of Medicine
    The Michael E. DeBakey VA Medical Center

    In addition, the third global MI Task Force updated the universal classification of MI with few notable modifications. The universal classification of MI complements the initial ECG classification of MI (as STEMI vs. non-STEMI), which should still be used clinically upfront to dictate immediate reperfusion strategy. In the third universal classification of MI, MI types 1 and 2 represent spontaneous MI (induced by plaque rupture, erosion, fissuring - with overlying coronary thrombosis) and MI induced by demand-supply imbalance in myocardial ischemia, respectively. Type 3 is MI resulting in cardiac death, while types 4 and 5 are PCI- and CABG-related MI.


    http://my.americanheart.org/professional/General/The-Third-Universal-Definition-of-Myocardial-Infarction-Clinical-Insights_UCM_443744_Article.jsp


    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

    [cid:image001.jpg@01D087E6.E90151B0]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:14 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    I reviewed the most recent 3M brief this week and they clarify that a type II MI is not an MI because there is no infarction (cell death). If not clarified, it will code to an MI but they recommend clarifying.

    I do not feel that I have enough clinical knowledge to make my own determination fo the clinical situation but I figured I would pass it on....

    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

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 11:08 AM
    To: Kathryn Good
    Subject: RE:[cdi_talk] CDI screening tools

    A type II MI due to 'whatever cause' does code to an acute AMI. An infarct is an infarct, regardless of the etiology.

    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

    [cid:image001.jpg@01D087E6.E90151B0]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:03 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Demand/Mismatch does not code to acute MI. It has been recommended that a query be initiated. This can affect many metrics. The cardiologists are even divided on this issue. Some cardiologists in our facility will dictate that although troponins are elevated this is not a MI but a supply demand mismatch issue. Other physicians, dictate that it is a MI with supply/demand mismatch. We struggle with this in our facility.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [cid:image002.jpg@01D087E6.E90151B0]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:54 AM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    Thank you!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:47 AM
    To: Cindy Slavin
    Subject: RE:[cdi_talk] CDI screening tools

    If a Type @ MI is clearly documented, it is coded as either an STMI or NSTMI, depending upon the specific statement in the record. Am MI due to demand/mismatch is an AMI. It has been stated by some on this site that some coders do not consider a Type II an MI; however, it is clear these are acute Myocardial Infarcts.


    [cid:image003.png@01D087E6.E90151B0]


    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

    [cid:image001.jpg@01D087E6.E90151B0]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 7:26 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Does anyone have an example query for when the physician documents Type 2 in the record? And how is it being coded. Tx!
    Cindy Slavin RN, BSN, CCDS
    Manager Clinical Appeals and Data Integrity
    Botsford Hospital
    248-615-7103

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:59 AM
    To: Cindy Slavin
    Subject: [cdi_talk] CDI screening tools

    Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again. I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share if they currently use one or have any ideas for one? Thanks!

    Jamie Dugan RN, CCDS
    Clinical Documentation Improvement Specialist
    3563 Philips Highway, Suite #106
    Jacksonville, Florida 32207
    Office: 904-202-4345

    ________________________________
    NOTICE: This message is confidential, intended for the named recipient(s) and may contain information that is (i) proprietary to the sender, and/or,(ii) privileged, confidential and/or otherwise exempt from disclosure under applicable Florida and federal law, including, but not limited to, privacy standards imposed pursuant to the federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Receipt by anyone other than the named recipient(s) is not a waiver of any applicable privilege. Thank you in advance for your compliance with this notice.



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  • Me Too! Thanks

    Theresa Crosslin RN CM
    Cookeville Regional Medical Center
    931-783-2078
    TCrosslin@crmchealth.org

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 12:08 PM
    To: Theresa Crosslin
    Subject: Re: [cdi_talk] CDI screening tools

    I would interested in seeing these as well. My email is ckitterman@pmh-ok.org.

    Thank-you,
    Christina Kitterman


    On Wednesday, May 6, 2015 9:13 AM, CDI Talk wrote:

    I also have some info Jamie


    Deanne Wilk, BSN, RN, CCDS, CCS
    AHIMA approved ICD-10-CM/PCS Trainer

    Clinical Documentation Improvement and Inpatient Coding Manager
    HIMS Department
    Good Samaritan Health System
    4th & Walnut Sts
    Lebanon, PA 17042
    dwilk@gshleb.org

    Phone: 717-270-7582
    Cell: 717-580-1436



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:09 AM
    To: Wilk, Deanne L.
    Subject: RE:[cdi_talk] CDI screening tools

    Jamie,
    I don’t see your e-mail address in your signature.
    Can you e-mail me?

    I have a few exams that I saved from a previous post regarding this topic I can send to you.

    Best,
    Greta


    Greta Goodman, CCDS
    Clinical Documentation Improvement Specialist
    Health Information Management
    Virginia Hospital Center
    1701 North George Mason Drive
    Arlington, VA 22205
    703-558-5336
    ggoodman@virginiahospitalcenter.com





    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:59 AM
    To: Goodman, Greta
    Subject: [cdi_talk] CDI screening tools

    Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again. I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share if they currently use one or have any ideas for one? Thanks!

    Jamie Dugan RN, CCDS
    Clinical Documentation Improvement Specialist
    3563 Philips Highway, Suite #106
    Jacksonville, Florida 32207
    Office: 904-202-4345

    ________________________________
    NOTICE: This message is confidential, intended for the named recipient(s) and may contain information that is (i) proprietary to the sender, and/or,(ii) privileged, confidential and/or otherwise exempt from disclosure under applicable Florida and federal law, including, but not limited to, privacy standards imposed pursuant to the federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Receipt by anyone other than the named recipient(s) is not a waiver of any applicable privilege. Thank you in advance for your compliance with this notice.



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    **********************************************************************************************************
    This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are addressed. This communication may contain personal patient health care information and is protected by federal law and other statutory protections. If you are not the intended recipient or the individual responsible for delivering the e-mail to the intended recipient, please be advised that you have received this e-mail in error and that any use, dissemination, forwarding, printing, or copying of this e-mail or any attached files is strictly prohibited. If you have received this e-mail in error, please promptly delete this message and notify the sender of the delivery error by e-mail or you may call Virginia Hospital Center -Arlington's Information Systems Department @703-558-6566.

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    This Message is intended only for the use of the individual or entity to which it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination or copying of this message or the taking of any action in reliance on the contents of this message is strictly prohibited. If you have received this message in error, please notify us immediately and destroy the original message. Thank you.

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  • I would be interested in receiving these also.
    Mary Lindenboom BSN, CCDS
    CDI Manager
    Flagler Hospital
    Saint Augustine, FL
    Mary.lindenboom@flaglerhospital.org

    Sent from my iPhone

    > On May 6, 2015, at 1:08 PM, CDI Talk wrote:
    >
    > I would interested in seeing these as well. My email is ckitterman@pmh-ok.org.
    >
    > Thank-you,
    > Christina Kitterman
    >
    >
    >
    > On Wednesday, May 6, 2015 9:13 AM, CDI Talk wrote:
    >
    >
    > I also have some info Jamie
    >
    >
    > Deanne Wilk, BSN, RN, CCDS, CCS
    > AHIMA approved ICD-10-CM/PCS Trainer
    >
    > Clinical Documentation Improvement and Inpatient Coding Manager
    > HIMS Department
    > Good Samaritan Health System
    > 4th & Walnut Sts
    > Lebanon, PA 17042
    > dwilk@gshleb.org
    >
    > Phone: 717-270-7582
    > Cell: 717-580-1436
    >
    >
    >
    > From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    > Sent: Wednesday, May 06, 2015 10:09 AM
    > To: Wilk, Deanne L.
    > Subject: RE:[cdi_talk] CDI screening tools
    >
    > Jamie,
    > I don’t see your e-mail address in your signature.
    > Can you e-mail me?
    >
    > I have a few exams that I saved from a previous post regarding this topic I can send to you.
    >
    > Best,
    > Greta
    >
    >
    > Greta Goodman, CCDS
    > Clinical Documentation Improvement Specialist
    > Health Information Management
    > Virginia Hospital Center
    > 1701 North George Mason Drive
    > Arlington, VA 22205
    > 703-558-5336
    > ggoodman@virginiahospitalcenter.com
    >
    >
    >
    >
    >
    >
    > From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    > Sent: Wednesday, May 06, 2015 9:59 AM
    > To: Goodman, Greta
    > Subject: [cdi_talk] CDI screening tools
    >
    > Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again. I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share if they currently use one or have any ideas for one? Thanks!
    >
    > Jamie Dugan RN, CCDS
    > Clinical Documentation Improvement Specialist
    > 3563 Philips Highway, Suite #106
    > Jacksonville, Florida 32207
    > Office: 904-202-4345
    >
    > NOTICE: This message is confidential, intended for the named recipient(s) and may contain information that is (i) proprietary to the sender, and/or,(ii) privileged, confidential and/or otherwise exempt from disclosure under applicable Florida and federal law, including, but not limited to, privacy standards imposed pursuant to the federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Receipt by anyone other than the named recipient(s) is not a waiver of any applicable privilege. Thank you in advance for your compliance with this notice.
    >
    > ---
    > CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
    >
    > You are receiving this message as a member of CDI Talk as: ggoodman@virginiahospitalcenter.com
    > If you would like to be removed from CDI Talk, please send a blank email to
    > leave-cdi_talk-12403641.651ab590aed3ab660e7b1e28bdf7052a@hcprotalk.com
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    --Apple-Mail-FD20BF7F-8C11-4544-A462-210905AA0FB4
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    I would be interested in receiving these also. Mary Lindenboom BSN, CCDSCDI ManagerFlagler HospitalSaint Augustine, FLMary.lindenboom@flaglerhospital.org

    Sent from my iPhone
    On May 6, 2015, at 1:08 PM, CDI Talk <cdi_talk@hcprotalk.com> wrote:
    I would interested in seeing these as well.  My email is ckitterman@pmh-ok.org. Thank-you,Christina Kitterman 


    On Wednesday, May 6, 2015 9:13 AM, CDI Talk <cdi_talk@hcprotalk.com> wrote:










    I also have some info Jamie
     

     
    Deanne Wilk, BSN, RN, CCDS, CCS
    AHIMA approved ICD-10-CM/PCS Trainer
     
    Clinical Documentation Improvement and Inpatient Coding Manager
    HIMS Department
    Good Samaritan Health System
    4th & Walnut Sts
    Lebanon, PA 17042
    dwilk@gshleb.org
     
    Phone:  717-270-7582
    Cell:  717-580-1436
     
     

     


    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]


    Sent: Wednesday, May 06, 2015 10:09 AM

    To: Wilk, Deanne L.

    Subject: RE:[cdi_talk] CDI screening tools


     
    Jamie,
    I don’t see your e-mail address in your signature.
    Can you e-mail me?
     
    I have a few exams that I saved from a previous post regarding this topic I can send to you.
     
    Best,
    Greta
     
     
    Greta Goodman, CCDS
    Clinical Documentation Improvement Specialist
    Health Information Management
    Virginia Hospital Center
    1701 North George Mason Drive
    Arlington, VA 22205
    703-558-5336
    ggoodman@virginiahospitalcenter.com
     
     
    CCDS_pin_1inch
     
     
     


    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]


    Sent: Wednesday, May 06, 2015 9:59 AM

    To: Goodman, Greta

    Subject: [cdi_talk] CDI screening tools


     
    Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again.  I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share
    if they currently use one or have any ideas for one? Thanks!
     
    Jamie Dugan RN, CCDS
    Clinical Documentation Improvement Specialist
    3563 Philips Highway, Suite #106
    Jacksonville, Florida  32207
    Office: 904-202-4345
     



    NOTICE: This message is confidential, intended for the named recipient(s) and may contain information that is (i) proprietary to the sender, and/or,(ii) privileged, confidential
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    image
     
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    This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are addressed. This communication may contain personal patient health care information and is protected by federal law
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    -Arlington's Information Systems Department @703-558-6566.



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    CDI-Talkers,
    Here are the few samples of CDI Exams I have.
    I'm sure you could piece them together to create one that fits your needs.
    Best,
    Greta


    Greta Goodman, CCDS
    Clinical Documentation Improvement Specialist
    Health Information Management
    Virginia Hospital Center
    1701 North George Mason Drive
    Arlington, VA 22205
    703-558-5336
    ggoodman@virginiahospitalcenter.com


    [CCDS_pin_1inch]





    ***************************************************************************=
    *******************************
    This e-mail and any files transmitted with it are confidential and are inte=
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    sed. This communication may contain personal patient health care informatio=
    n and is protected by federal law and other statutory protections. If you a=
    re not the intended recipient or the individual responsible for delivering =
    the e-mail to the intended recipient, please be advised that you have recei=
    ved this e-mail in error and that any use, dissemination, forwarding, print=
    ing, or copying of this e-mail or any attached files is strictly prohibited=
    . If you have received this e-mail in error, please promptly delete this me=
    ssage and notify the sender of the delivery error by e-mail or you may call=
    Virginia Hospital Center -Arlington's Information Systems Department @703-=
    558-6566.
    =

    ***************************************************************************=
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    CDI-Talkers,

    Here are the few sampl=
    es of CDI Exams I have.

    I’m sure you cou=
    ld piece them together to create one that fits your needs.

    Best,

    Greta

     

     

    Greta Goodman, CCDS

    Clinical Documentation Improvement Specialist

    Health Information Management

    Virginia Hospital Center

    1701 North George Mason Drive

    Arlington, VA 22205

    703-558-5336=

    ggoodma=
    n@virginiahospitalcenter.com

     

     

     

     

     

    image



    ********************************************************************=
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    This e-mail and any files transmitted with it are confidential and are inte=
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    ssage and notify the sender of the delivery error by e-mail or you may call=
    Virginia Hospital Center -Arlington's Information Systems Department @703-=
    558-6566.



    ***************************************************************************=
    ********************************


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    AAAAAAAAAAoQAAAPhIAWEYSY/l6EgBZghJj+h2gAAAAAiEgAAAIABwAuAAEAAAACggEAAAAAAAAA
    AAAAAAAAAAAAAAoQAAAPhFAZEYRM/16EUBlghEz/h2gAAAAAiEgAAAIACAAuAAEAAAAAAAEAAAAA
    AAAAAAAAAAAAAAAAAAMYAAAPhNACEYSY/hXGBQAB0AIGXoTQAmCEmP5vKAACAAAAKQABAAAAAwAB
    AAAAAAAAAAAAAAAAAAAAAAADGAAAD4SgBRGEmP4VxgUAAaAFBl6EoAVghJj+bygAAgABACkAAQAA
    AAICAQAAAAAAAAAAAAAAAAAAAAAAChgAAA+EcAgRhEz/FcYFAAFwCAZehHAIYIRM/4doAAAAAIhI
    AAACAAIALgABAAAAAIABAAAAAAAAAAAAAAAAAAAAAAAKGAAAD4RACxGEmP4VxgUAAUALBl6EQAtg
    hJj+h2gAAAAAiEgAAAIAAwAuAAEAAAAEgAEAAAAAAAAAAAAAAAAAAAAAAAoYAAAPhBAOEYSY/hXG
    BQABEA4GXoQQDmCEmP6HaAAAAACISAAAAgAEAC4AAQAAAAKCAQAAAAAAAAAAAAAAAAAAAAAAChgA
    AA+E4BARhEz/FcYFAAHgEAZehOAQYIRM/4doAAAAAIhIAAACAAUALgABAAAAAIABAAAAAAAAAAAA
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    AgAHAC4AAQAAAAKCAQAAAAAAAAAAAAAAAAAAAAAAChgAAA+EUBkRhEz/FcYFAAFQGQZehFAZYIRM
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    h2gAAAAAiEgAAAIAAQAuAAEAAAACggEAAAAAAAAAAAAAAAAAAAAAAAoQAAAPhNgJEYRM/16E2Alg
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    qAxghJj+h2gAAAAAiEgAAAIAAwAuAAEAAAAEgAEAAAAAAAAAAAAAAAAAAAAAAAoQAAAPhHgPEYSY
    /l6EeA9ghJj+h2gAAAAAiEgAAAIABAAuAAEAAAACggEAAAAAAAAAAAAAAAAAAAAAAAoQAAAPhEgS
    EYRM/16ESBJghEz/h2gAAAAAiEgAAAIABQAuAAEAAAAAgAEAAAAAAAAAAAAAAAAAAAAAAAoQAAAP
    hBgVEYSY/l6EGBVghJj+h2gAAAAAiEgAAAIABgAuAAEAAAAEgAEAAAAAAAAAAAAAAAAAAAAAAAoQ
    AAAPhOgXEYSY/l6E6BdghJj+h2gAAAAAiEgAAAIABwAuAAEAAAACggEAAAAAAAAAAAAAAAAAAAAA
    AAoQAAAPhLgaEYRM/16EuBpghEz/h2gAAAAAiEgAAAIACAAuAAMAAACACItrAAAAAAAAAAAAAAAA
    gkRzFwAAAAAAAAAAAAAAALRSo3wAAAAAAAAAAAAAAAD//////////////////wMAAAAAAAAAAAD/
    /wMAAAASABEACQQZAAkEGwAJBA8ACQQZAAkEGwAJBA8ACQQZAAkEGwAJBBIAEQAJBP4vJiwbAAkE
    DwAJBBkACQQbAAkEDwAJBBkACQQbAAkEEgCOT4QsGQAJBBsACQQPAAkEGQAJBBsACQQPAAkEGQAJ
    BBsACQQFAAAABAAAAAgAAADlAAAAAAAAAAQAAABsdAoAl3lAAAA/YgABZ3kAHUr8AAAAAADeFQAA
    4BUAAAAAAAABAAAA/0ACNAAAAAAAAAAAEAAAABEAAOUUAADeFQAAWAAAEABAAABYAAAYAAAAAFgA
    ADQAQAAAWAAAWABAAAD//wEAAAAHAFUAbgBrAG4AbwB3AG4A//8BAAgAAAAAAAAAAAAAAP//AQAA
    AAAA//8AAAIA//8AAAAA//8AAAIA//8AAAAABQAAAEcekAEAAAICBgMFBAUCAwSHKgAgAAAAgAgA
    AAAAAAAA/wEAAAAAAABUAGkAbQBlAHMAIABOAGUAdwAgAFIAbwBtAGEAbgAAADUekAECAAUFAQIB
    BwYCBQcAAAAAAAAAEAAAAAAAAAAAAAAAgAAAAABTAHkAbQBiAG8AbAAAADMukAEAAAILBgQCAgIC
    AgSHKgAgAAAAgAgAAAAAAAAA/wEAAAAAAABBAHIAaQBhAGwAAAA3LpABAAACDwUCAgIEAwIE7wIA
    oHsgAEAAAAAAAAAAAJ8AAAAAAAAAQwBhAGwAaQBiAHIAaQAAAEEekAEAAAIEBQMFBAYDAgTvAgCg
    6yAAQgAAAAAAAAAAnwAAAAAAAABDAGEAbQBiAHIAaQBhACAATQBhAHQAaAAAACIABABxCIgYAPDQ
    AgAAaAEAAAAAXbIpJ4czNWcAAAAABAAJAAAAQwMAAJsSAAAFAAsAAAAEAAMQJwAAAEMDAACbEgAA
    BQALAAAAJwAAAAAAAAAhAwDwEAAAAAEAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
    AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
    AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
    AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
    AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
  • Do you have the answers?



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Thursday, May 07, 2015 7:21 AM
    Subject: [cdi_talk] CDI Screening Tools

    CDI-Talkers,
    Here are the few samples of CDI Exams I have.
    I'm sure you could piece them together to create one that fits your needs.
    Best,
    Greta


    Greta Goodman, CCDS
    Clinical Documentation Improvement Specialist
    Health Information Management
    Virginia Hospital Center
    1701 North George Mason Drive
    Arlington, VA 22205
    703-558-5336
    ggoodman@virginiahospitalcenter.com


    [CCDS_pin_1inch]





    [http://extranet.acsysweb.com/vsitemanager/VirginiaHosp/Public/Upload/Images/100_Top_Hospitals_Virginia_Hospital_Center_signature.png]


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    This message and attachment(s), if any, is intended for the sole use of the individual and/or entity
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  • No I don't have any answer keys.
    Sorry.
    But I'm sure you could work through them on your own!
    If you can't figure out the answer, it's probably not a fair question to give an applicant ;)

    Best,
    Greta


    Greta Goodman, CCDS
    Clinical Documentation Improvement Specialist
    Health Information Management
    Virginia Hospital Center
    1701 North George Mason Drive
    Arlington, VA 22205
    703-558-5336
    ggoodman@virginiahospitalcenter.com


    [CCDS_pin_1inch]



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Thursday, May 07, 2015 9:18 AM
    To: Goodman, Greta
    Subject: RE:[cdi_talk] CDI Screening Tools

    Do you have the answers?



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Thursday, May 07, 2015 7:21 AM
    Subject: [cdi_talk] CDI Screening Tools

    CDI-Talkers,
    Here are the few samples of CDI Exams I have.
    I'm sure you could piece them together to create one that fits your needs.
    Best,
    Greta


    Greta Goodman, CCDS
    Clinical Documentation Improvement Specialist
    Health Information Management
    Virginia Hospital Center
    1701 North George Mason Drive
    Arlington, VA 22205
    703-558-5336
    ggoodman@virginiahospitalcenter.com


    [CCDS_pin_1inch]





    [Image removed by sender.]


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    This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are addressed. This communication may contain personal patient health care information and is protected by federal law and other statutory protections. If you are not the intended recipient or the individual responsible for delivering the e-mail to the intended recipient, please be advised that you have received this e-mail in error and that any use, dissemination, forwarding, printing, or copying of this e-mail or any attached files is strictly prohibited. If you have received this e-mail in error, please promptly delete this message and notify the sender of the delivery error by e-mail or you may call Virginia Hospital Center -Arlington's Information Systems Department @703-558-6566.

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    This message and attachment(s), if any, is intended for the sole use of the individual and/or entity of which it is addressed, and may contain information that is privileged,confidential and prohibited from disclosure under applicable law. If you are not the addressee, or authorized to receive this on behalf of the addressee, you are hereby notified that you may not use, copy, disclose or distribute to anyone this message or any part thereof. If you have received this in error, please immediately advise the sender by e-mail and delete this information and all attachments from your computer and network. Thank you.



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    This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are addressed. This communication may contain personal patient health care information and is protected by federal law and other statutory protections. If you are not the intended recipient or the individual responsible for delivering the e-mail to the intended recipient, please be advised that you have received this e-mail in error and that any use, dissemination, forwarding, printing, or copying of this e-mail or any attached files is strictly prohibited. If you have received this e-mail in error, please promptly delete this message and notify the sender of the delivery error by e-mail or you may call Virginia Hospital Center -Arlington's Information Systems Department @703-558-6566.

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  • Thanks Greta~ I think these are great.



    Claudine Hutchinson RN (CDI)



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Thursday, May 07, 2015 07:21 AM
    To: Hutchinson, Claudine
    Subject: [cdi_talk] CDI Screening Tools



    CDI-Talkers,

    Here are the few samples of CDI Exams I have.

    I'm sure you could piece them together to create one that fits your
    needs.

    Best,

    Greta





    Greta Goodman, CCDS

    Clinical Documentation Improvement Specialist

    Health Information Management

    Virginia Hospital Center

    1701 North George Mason Drive

    Arlington, VA 22205

    703-558-5336

    ggoodman@virginiahospitalcenter.com

















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    This e-mail and any files transmitted with it are confidential and are
    intended solely for the use of the individual or entity to whom they are
    addressed. This communication may contain personal patient health care
    information and is protected by federal law and other statutory
    protections. If you are not the intended recipient or the individual
    responsible for delivering the e-mail to the intended recipient, please
    be advised that you have received this e-mail in error and that any use,
    dissemination, forwarding, printing, or copying of this e-mail or any
    attached files is strictly prohibited. If you have received this e-mail
    in error, please promptly delete this message and notify the sender of
    the delivery error by e-mail or you may call Virginia Hospital Center
    -Arlington's Information Systems Department @703-558-6566.

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    Saint Francis Health System intends this email only for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If you have received this email in error, you are hereby notified that we do not consent to any reading, dissemination, distribution, or copying of this email and request you notify the sender immediately and destroy this transmission. Violators may be prosecuted under Federal law.
  • Thanks Paul. This really helps. I look forward to sharing it with our MDs. Thanks for your continued feedback on many issues.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [Description: CCDS_pin_1inch]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 12:26 PM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    3M is not official advice - per 3rd Universal Definition, this is an MI.
    The Third Universal Definition of Myocardial Infarction: Clinical Insights and Implications
    Disclosure: Dr. Jneid has nothing to disclose.
    Pub Date: Saturday, Aug. 25, 2012
    Author: Hani Jneid, MD, FACC, FAHA, FSCAI
    Affiliation: Baylor College of Medicine
    The Michael E. DeBakey VA Medical Center

    In addition, the third global MI Task Force updated the universal classification of MI with few notable modifications. The universal classification of MI complements the initial ECG classification of MI (as STEMI vs. non-STEMI), which should still be used clinically upfront to dictate immediate reperfusion strategy. In the third universal classification of MI, MI types 1 and 2 represent spontaneous MI (induced by plaque rupture, erosion, fissuring - with overlying coronary thrombosis) and MI induced by demand-supply imbalance in myocardial ischemia, respectively. Type 3 is MI resulting in cardiac death, while types 4 and 5 are PCI- and CABG-related MI.


    http://my.americanheart.org/professional/General/The-Third-Universal-Definition-of-Myocardial-Infarction-Clinical-Insights_UCM_443744_Article.jsp


    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

    [cid:image001.jpg@01CE983E.025F5700]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:14 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    I reviewed the most recent 3M brief this week and they clarify that a type II MI is not an MI because there is no infarction (cell death). If not clarified, it will code to an MI but they recommend clarifying.

    I do not feel that I have enough clinical knowledge to make my own determination fo the clinical situation but I figured I would pass it on....

    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

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 11:08 AM
    To: Kathryn Good
    Subject: RE:[cdi_talk] CDI screening tools

    A type II MI due to 'whatever cause' does code to an acute AMI. An infarct is an infarct, regardless of the etiology.

    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

    [cid:image001.jpg@01CE983E.025F5700]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:03 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Demand/Mismatch does not code to acute MI. It has been recommended that a query be initiated. This can affect many metrics. The cardiologists are even divided on this issue. Some cardiologists in our facility will dictate that although troponins are elevated this is not a MI but a supply demand mismatch issue. Other physicians, dictate that it is a MI with supply/demand mismatch. We struggle with this in our facility.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [Description: CCDS_pin_1inch]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:54 AM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    Thank you!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:47 AM
    To: Cindy Slavin
    Subject: RE:[cdi_talk] CDI screening tools

    If a Type @ MI is clearly documented, it is coded as either an STMI or NSTMI, depending upon the specific statement in the record. Am MI due to demand/mismatch is an AMI. It has been stated by some on this site that some coders do not consider a Type II an MI; however, it is clear these are acute Myocardial Infarcts.


    [cid:image005.png@01D088A7.8C2E60B0]


    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

    [cid:image001.jpg@01CE983E.025F5700]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 7:26 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Does anyone have an example query for when the physician documents Type 2 in the record? And how is it being coded. Tx!
    Cindy Slavin RN, BSN, CCDS
    Manager Clinical Appeals and Data Integrity
    Botsford Hospital
    248-615-7103

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:59 AM
    To: Cindy Slavin
    Subject: [cdi_talk] CDI screening tools

    Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again. I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share if they currently use one or have any ideas for one? Thanks!

    Jamie Dugan RN, CCDS
    Clinical Documentation Improvement Specialist
    3563 Philips Highway, Suite #106
    Jacksonville, Florida 32207
    Office: 904-202-4345

    ________________________________
    NOTICE: This message is confidential, intended for the named recipient(s) and may contain information that is (i) proprietary to the sender, and/or,(ii) privileged, confidential and/or otherwise exempt from disclosure under applicable Florida and federal law, including, but not limited to, privacy standards imposed pursuant to the federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Receipt by anyone other than the named recipient(s) is not a waiver of any applicable privilege. Thank you in advance for your compliance with this notice.



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    CONFIDENTIALITY NOTICE: Confidential information, such as identifiable patient health information or business information, is subject to protection under state and federal law. If you are not the intended recipient of this message, you may not disclose, print, copy or disseminate this information. If you have received this in error, please reply and notify the sender (only) and delete the message. Unauthorized interception of this e-mail is a violation of federal criminal law.
  • Thanks Katy. This is the same that I have been told in the past.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [Description: CCDS_pin_1inch]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 12:14 PM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    I reviewed the most recent 3M brief this week and they clarify that a type II MI is not an MI because there is no infarction (cell death). If not clarified, it will code to an MI but they recommend clarifying.

    I do not feel that I have enough clinical knowledge to make my own determination fo the clinical situation but I figured I would pass it on....

    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

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 11:08 AM
    To: Kathryn Good
    Subject: RE:[cdi_talk] CDI screening tools

    A type II MI due to 'whatever cause' does code to an acute AMI. An infarct is an infarct, regardless of the etiology.

    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

    [cid:image001.jpg@01CE983E.025F5700]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:03 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Demand/Mismatch does not code to acute MI. It has been recommended that a query be initiated. This can affect many metrics. The cardiologists are even divided on this issue. Some cardiologists in our facility will dictate that although troponins are elevated this is not a MI but a supply demand mismatch issue. Other physicians, dictate that it is a MI with supply/demand mismatch. We struggle with this in our facility.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [Description: CCDS_pin_1inch]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:54 AM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    Thank you!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:47 AM
    To: Cindy Slavin
    Subject: RE:[cdi_talk] CDI screening tools

    If a Type @ MI is clearly documented, it is coded as either an STMI or NSTMI, depending upon the specific statement in the record. Am MI due to demand/mismatch is an AMI. It has been stated by some on this site that some coders do not consider a Type II an MI; however, it is clear these are acute Myocardial Infarcts.


    [cid:image005.png@01D088A8.3D018F20]


    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

    [cid:image001.jpg@01CE983E.025F5700]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 7:26 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Does anyone have an example query for when the physician documents Type 2 in the record? And how is it being coded. Tx!
    Cindy Slavin RN, BSN, CCDS
    Manager Clinical Appeals and Data Integrity
    Botsford Hospital
    248-615-7103

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:59 AM
    To: Cindy Slavin
    Subject: [cdi_talk] CDI screening tools

    Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again. I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share if they currently use one or have any ideas for one? Thanks!

    Jamie Dugan RN, CCDS
    Clinical Documentation Improvement Specialist
    3563 Philips Highway, Suite #106
    Jacksonville, Florida 32207
    Office: 904-202-4345

    ________________________________
    NOTICE: This message is confidential, intended for the named recipient(s) and may contain information that is (i) proprietary to the sender, and/or,(ii) privileged, confidential and/or otherwise exempt from disclosure under applicable Florida and federal law, including, but not limited to, privacy standards imposed pursuant to the federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Receipt by anyone other than the named recipient(s) is not a waiver of any applicable privilege. Thank you in advance for your compliance with this notice.



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    CONFIDENTIALITY NOTICE: Confidential information, such as identifiable patient health information or business information, is subject to protection under state and federal law. If you are not the intended recipient of this message, you may not disclose, print, copy or disseminate this information. If you have received this in error, please reply and notify the sender (only) and delete the message. Unauthorized interception of this e-mail is a violation of federal criminal law.



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    CONFIDENTIALITY NOTICE: Confidential information, such as identifiable patient health information or business information, is subject to protection under state and federal law. If you are not the intended recipient of this message, you may not disclose, print, copy or disseminate this information. If you have received this in error, please reply and notify the sender (only) and delete the message. Unauthorized interception of this e-mail is a violation of federal criminal law.
  • My pleasure....Regarding 3M, did not mean to sound abrupt, but I am swamped this week. My messages are always brief.

    I would only say that 3M, while a fine consulting group, is a Consulting Group, and their opinion, while it should be considered, is not official. I say this because many, many times in my work others have also stated that 3M issued advice, and said advice was accepted as final. I can tell you that I do not always agree with their advice, and they are not infallible. Also bear in mind that 'we' are generally expected to code 'what is stated by the MD'.

    I agree myocardial ischemia or ACE does not always mean the patient had an MI. However, it is not valid to indicate that a type II MI is always coded as ACS. Our team always evaluates the terms relating to ACS, Ischemia, AMI using the clinical criteria we have had approved for the Universal Definition of an MI.

    I'd suggest we cite and use literature that is accepted by clinicians w/ references also to Official Coding Guidelines, Coding Clinic, et al.

    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

    [cid:image001.jpg@01D088A1.AC17FDB0]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Thursday, May 07, 2015 7:24 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Thanks Paul. This really helps. I look forward to sharing it with our MDs. Thanks for your continued feedback on many issues.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [cid:image002.jpg@01D088A1.AC17FDB0]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 12:26 PM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    3M is not official advice - per 3rd Universal Definition, this is an MI.
    The Third Universal Definition of Myocardial Infarction: Clinical Insights and Implications
    Disclosure: Dr. Jneid has nothing to disclose.
    Pub Date: Saturday, Aug. 25, 2012
    Author: Hani Jneid, MD, FACC, FAHA, FSCAI
    Affiliation: Baylor College of Medicine
    The Michael E. DeBakey VA Medical Center

    In addition, the third global MI Task Force updated the universal classification of MI with few notable modifications. The universal classification of MI complements the initial ECG classification of MI (as STEMI vs. non-STEMI), which should still be used clinically upfront to dictate immediate reperfusion strategy. In the third universal classification of MI, MI types 1 and 2 represent spontaneous MI (induced by plaque rupture, erosion, fissuring - with overlying coronary thrombosis) and MI induced by demand-supply imbalance in myocardial ischemia, respectively. Type 3 is MI resulting in cardiac death, while types 4 and 5 are PCI- and CABG-related MI.


    http://my.americanheart.org/professional/General/The-Third-Universal-Definition-of-Myocardial-Infarction-Clinical-Insights_UCM_443744_Article.jsp


    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

    [cid:image001.jpg@01D088A1.AC17FDB0]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:14 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    I reviewed the most recent 3M brief this week and they clarify that a type II MI is not an MI because there is no infarction (cell death). If not clarified, it will code to an MI but they recommend clarifying.

    I do not feel that I have enough clinical knowledge to make my own determination fo the clinical situation but I figured I would pass it on....

    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

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 11:08 AM
    To: Kathryn Good
    Subject: RE:[cdi_talk] CDI screening tools

    A type II MI due to 'whatever cause' does code to an acute AMI. An infarct is an infarct, regardless of the etiology.

    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

    [cid:image001.jpg@01D088A1.AC17FDB0]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:03 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Demand/Mismatch does not code to acute MI. It has been recommended that a query be initiated. This can affect many metrics. The cardiologists are even divided on this issue. Some cardiologists in our facility will dictate that although troponins are elevated this is not a MI but a supply demand mismatch issue. Other physicians, dictate that it is a MI with supply/demand mismatch. We struggle with this in our facility.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [cid:image002.jpg@01D088A1.AC17FDB0]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:54 AM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    Thank you!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:47 AM
    To: Cindy Slavin
    Subject: RE:[cdi_talk] CDI screening tools

    If a Type @ MI is clearly documented, it is coded as either an STMI or NSTMI, depending upon the specific statement in the record. Am MI due to demand/mismatch is an AMI. It has been stated by some on this site that some coders do not consider a Type II an MI; however, it is clear these are acute Myocardial Infarcts.


    [cid:image003.png@01D088A1.AC17FDB0]


    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

    [cid:image001.jpg@01D088A1.AC17FDB0]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 7:26 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Does anyone have an example query for when the physician documents Type 2 in the record? And how is it being coded. Tx!
    Cindy Slavin RN, BSN, CCDS
    Manager Clinical Appeals and Data Integrity
    Botsford Hospital
    248-615-7103

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:59 AM
    To: Cindy Slavin
    Subject: [cdi_talk] CDI screening tools

    Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again. I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share if they currently use one or have any ideas for one? Thanks!

    Jamie Dugan RN, CCDS
    Clinical Documentation Improvement Specialist
    3563 Philips Highway, Suite #106
    Jacksonville, Florida 32207
    Office: 904-202-4345

    ________________________________
    NOTICE: This message is confidential, intended for the named recipient(s) and may contain information that is (i) proprietary to the sender, and/or,(ii) privileged, confidential and/or otherwise exempt from disclosure under applicable Florida and federal law, including, but not limited to, privacy standards imposed pursuant to the federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Receipt by anyone other than the named recipient(s) is not a waiver of any applicable privilege. Thank you in advance for your compliance with this notice.



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    CONFIDENTIALITY NOTICE: Confidential information, such as identifiable patient health information or business information, is subject to protection under state and federal law. If you are not the intended recipient of this message, you may not disclose, print, copy or disseminate this information. If you have received this in error, please reply and notify the sender (only) and delete the message. Unauthorized interception of this e-mail is a violation of federal criminal law.



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  • I didn't take it that way Paul. I agree with you. it's not official guidance, it's just one opinion. I think this is a pretty nebulous issue and we have had varying opinions expressed by our own cardiologists so I don't think there is a true consensus. I also agree that we code what physicians say. So (without clarification) a type II MI would code to an MI. I think where the variation is whether we should be querying when we see this documentation and in which circumstances is that appropriate.
    I always appreciate your input :)

    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

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Thursday, May 07, 2015 9:42 AM
    To: Kathryn Good
    Subject: RE:[cdi_talk] CDI screening tools

    My pleasure....Regarding 3M, did not mean to sound abrupt, but I am swamped this week. My messages are always brief.

    I would only say that 3M, while a fine consulting group, is a Consulting Group, and their opinion, while it should be considered, is not official. I say this because many, many times in my work others have also stated that 3M issued advice, and said advice was accepted as final. I can tell you that I do not always agree with their advice, and they are not infallible. Also bear in mind that 'we' are generally expected to code 'what is stated by the MD'.

    I agree myocardial ischemia or ACE does not always mean the patient had an MI. However, it is not valid to indicate that a type II MI is always coded as ACS. Our team always evaluates the terms relating to ACS, Ischemia, AMI using the clinical criteria we have had approved for the Universal Definition of an MI.

    I'd suggest we cite and use literature that is accepted by clinicians w/ references also to Official Coding Guidelines, Coding Clinic, et al.

    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

    [cid:image001.jpg@01D088AA.F694D030]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Thursday, May 07, 2015 7:24 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Thanks Paul. This really helps. I look forward to sharing it with our MDs. Thanks for your continued feedback on many issues.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [cid:image002.jpg@01D088AA.F694D030]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 12:26 PM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    3M is not official advice - per 3rd Universal Definition, this is an MI.
    The Third Universal Definition of Myocardial Infarction: Clinical Insights and Implications
    Disclosure: Dr. Jneid has nothing to disclose.
    Pub Date: Saturday, Aug. 25, 2012
    Author: Hani Jneid, MD, FACC, FAHA, FSCAI
    Affiliation: Baylor College of Medicine
    The Michael E. DeBakey VA Medical Center

    In addition, the third global MI Task Force updated the universal classification of MI with few notable modifications. The universal classification of MI complements the initial ECG classification of MI (as STEMI vs. non-STEMI), which should still be used clinically upfront to dictate immediate reperfusion strategy. In the third universal classification of MI, MI types 1 and 2 represent spontaneous MI (induced by plaque rupture, erosion, fissuring - with overlying coronary thrombosis) and MI induced by demand-supply imbalance in myocardial ischemia, respectively. Type 3 is MI resulting in cardiac death, while types 4 and 5 are PCI- and CABG-related MI.


    http://my.americanheart.org/professional/General/The-Third-Universal-Definition-of-Myocardial-Infarction-Clinical-Insights_UCM_443744_Article.jsp


    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

    [cid:image001.jpg@01D088AA.F694D030]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:14 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    I reviewed the most recent 3M brief this week and they clarify that a type II MI is not an MI because there is no infarction (cell death). If not clarified, it will code to an MI but they recommend clarifying.

    I do not feel that I have enough clinical knowledge to make my own determination fo the clinical situation but I figured I would pass it on....

    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

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 11:08 AM
    To: Kathryn Good
    Subject: RE:[cdi_talk] CDI screening tools

    A type II MI due to 'whatever cause' does code to an acute AMI. An infarct is an infarct, regardless of the etiology.

    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

    [cid:image001.jpg@01D088AA.F694D030]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:03 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Demand/Mismatch does not code to acute MI. It has been recommended that a query be initiated. This can affect many metrics. The cardiologists are even divided on this issue. Some cardiologists in our facility will dictate that although troponins are elevated this is not a MI but a supply demand mismatch issue. Other physicians, dictate that it is a MI with supply/demand mismatch. We struggle with this in our facility.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [cid:image002.jpg@01D088AA.F694D030]
    "We are His hands". Isaiah 64:8

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:54 AM
    To: Hudson, Cynthia
    Subject: RE:[cdi_talk] CDI screening tools

    Thank you!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 10:47 AM
    To: Cindy Slavin
    Subject: RE:[cdi_talk] CDI screening tools

    If a Type @ MI is clearly documented, it is coded as either an STMI or NSTMI, depending upon the specific statement in the record. Am MI due to demand/mismatch is an AMI. It has been stated by some on this site that some coders do not consider a Type II an MI; however, it is clear these are acute Myocardial Infarcts.


    [cid:image003.png@01D088AA.F694D030]


    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

    [cid:image001.jpg@01D088AA.F694D030]

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 7:26 AM
    To: Evans, Paul
    Subject: RE:[cdi_talk] CDI screening tools

    Does anyone have an example query for when the physician documents Type 2 in the record? And how is it being coded. Tx!
    Cindy Slavin RN, BSN, CCDS
    Manager Clinical Appeals and Data Integrity
    Botsford Hospital
    248-615-7103

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, May 06, 2015 9:59 AM
    To: Cindy Slavin
    Subject: [cdi_talk] CDI screening tools

    Good morning everyone. I posted yesterday, but really not get any feedback. So I am trying once again. I have seen on CDI talk previously some posts regarding screening tools (exams) for CDI candidates. Would anyone be willing to share if they currently use one or have any ideas for one? Thanks!

    Jamie Dugan RN, CCDS
    Clinical Documentation Improvement Specialist
    3563 Philips Highway, Suite #106
    Jacksonville, Florida 32207
    Office: 904-202-4345

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  • Thanks, Katy.

    We use this definition in our practice. Our Cardiologist are on board with this reference. I have found it very helpful to cite this in our work as often there may be considerable dissonance regarding the documentation of 'myocardial ischemia, ACS, AMI".


    CLINICAL REFERENCE

    * My necrosis:
    - An elevation of troponin above the 99th percentile of normal.
    * Myocardial infarction (Myonecrosis 2
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