Concurrent coding

loretta.hoffmeister@samcstl.orgloretta.hoffmeister@samcstl.org
in CDI Talk Archive
Just wanting to get info/opinions from anyone who currently or in the past have participated in a "concurrent coding process". How did your process work? How did CDI participate in this concurrent coding process? Were your coders on site or off site? CDI on site or off site? How many CDI's did you have and what was their primary role?

Thank you!
Loretta
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Comments

  • Linda.Harris@LPNT.netLinda.Harris@LPNT.net
    edited April 2016
    Our concurrent coding process is performed by our coding staff and she generate the queries for the physicians' and I print them and take to the physicians for review. Our coder is off site, we use Chart-Wise as our vendor.

    Linda
  • martin.conroymartin.conroy
    edited April 2016
    We actually began concurrently coding as an alternative to onsite CDI. Concurrent coding is done remotely and they send queries to HIM to chart on the floor. We decided after 2 years (and knowing ICD-10 was coming) onsite support was needed so we added onsite CDI nurses. CDI nurses receive a twice a day report with DRGs, DX, PX, & suggested CDI questions. Makes onsite CDI very productive! CDI onsite team currently 3 nurses, me & two open positions. Left open positions go until after ICD-10 now I am going to fill prior to holidays. We cover two hospitals. One teaching/trauma and one community. Onsite team is primarily in the units to be onsite resource & add more queries to the process. Onsite team also conducts education (especially residents).

    Hospital leadership is extremely supportive of concurrent coding as we can produce daily in-house LOS, CMI, MCC/CC, SOI, ROM, PSI & HAC reports.

    My onsite nurses are trained to code but rarely need to so they can focus on documentation guidance. Discharge coding loves the fact all assigned diagnosis codes include the location in the record they are found for quick validation.

    Marty
    Temple Health

  • Unknown
    edited April 2016
    We had two clients who went with concurrent coding as their CDI initiative - they saw fewer than 5 cases a day. WE will NEVER participate in any program where concurrent coding is done for CDI - it's a waste of time and resources.

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)

  • loretta.hoffmeister@samcstl.orgloretta.hoffmeister@samcstl.org
    edited April 2016
    Dr Gold - when you say "they saw fewer than 5 cases a day" do you mean that the coder productivity only met 5 cases per day (coder productivity was lost)?
    Did those facilities also have a CDI dept, or did they only use the coders for the concurrent process? Thank you for your input in advance.

  • Unknown
    edited April 2016
    The facility asked for our CDI program. They wanted three coders trained to do concurrent coding and CDI at the same time. They only saw five cases a day - on a good day. Both coder productivity and CDI productivity was poor. They had no other CDI initiative. Our usual program leads to CDI folks doing CDI (coding professional or nurse) and not computing DRGs at all. Coding productivity increased when the docs, who were educated physician to physician, provided all the documentation the coders would ever want. The CDI team reviewed 30 - 45 records a day easily.

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)


  • tcrosslintcrosslin
    edited April 2016
    Dr Gold what program do you recommend using for CDI training. I have done the HCPRO Bootcamp but still am not comfortable in this role. Our coders do all the Queries and really do not want me to do any.

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

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    I have worked on the floor concurrently coding charts and also issuing a query, if/when required...so worked in coding and CDI function concurrently.

    I did not 'final' code any case, as my objective was to 'rough' code each case and then determine if/when a 'query' was desired. If so, I'd issue the query and assign codes as per query response. I'd code the case each day until day of D/C, leaving my list of suggested codes of major conditions for the final coder. That person performed final coding with the summary, performed final edits, and submitted for final billing.

    Advantage: Concurrent review very helpful, and great to have communication in real time.

    Disadvantage: I was not as 'productive' as a person performing solely one function or the other.


    PE

    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@01D10A7A.E53DDE60]

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