Query burn out
Hello fellow CDI's, I have a few questions...
1. How do you prevent query burn out with your doc's, but still be accurate with your queries that do and do not make a difference.
2. Do you list all of your diagnosis for your coders that make a difference or not?
3. How often do you look at your charts concurrently after admission, including your long stays (ICU)
4. When coding, do you get your APR-DRG and move on...or do you hold onto your charts until d/c, ICU's and medical charts.
Thanks in advance for your comments.
Stephanie CDI team CHOP
1. How do you prevent query burn out with your doc's, but still be accurate with your queries that do and do not make a difference.
2. Do you list all of your diagnosis for your coders that make a difference or not?
3. How often do you look at your charts concurrently after admission, including your long stays (ICU)
4. When coding, do you get your APR-DRG and move on...or do you hold onto your charts until d/c, ICU's and medical charts.
Thanks in advance for your comments.
Stephanie CDI team CHOP
Comments
1. With a Ladd's procedure, do you code every portion of the bowel - duodenum, jejunum, ileum, cecum, ascending colon, transverse colon, descending colon, sigmoid colon, etc?
2. The surgeon states small bowel moved to the right and large colon moved to the left. If the surgeon would state "entire
small colon or "entire" large colon, is this acceptable and can the coder code all segments of the large and small colon? Do the CDSs need to query for each portion of the colon?
Thank you.
Mary Anne
Visit us at Precyse.com!
-----Original Message-----
From: Pediatric CDI Talk [mailto:pediatric_cdi_talk@hcprotalk.com]
Sent: Monday, April 04, 2016 3:15 PM
To: Mary Anne Fisanick
Subject: [pediatric_cdi_talk] Query burn out
Hello fellow CDI's, I have a few questions...
1. How do you prevent query burn out with your doc's, but still be accurate with your queries that do and do not make a difference.
2. Do you list all of your diagnosis for your coders that make a difference or not?
3. How often do you look at your charts concurrently after admission, including your long stays (ICU)
4. When coding, do you get your APR-DRG and move on...or do you hold onto your charts until d/c, ICU's and medical charts.
Thanks in advance for your comments.
Stephanie CDI team CHOP
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Please see below for responses:
1. How do you prevent query burn out with your doc's, but still be accurate with your queries that do and do not make a difference.
We query for CCs and MCCs off the bat. But, as you know, SOI/ROM makes a huge difference, so my general practice is to query for appropriate diagnoses (presence of indicators, risk factors, treatment) with SOI of 2 or above if it looks like it will move the final SOI/ROM. To try to assist in developing consistent documentation habits, I will also query for linkages of organism with pneumonia (sometimes but not always will impact DRG and/or SOI), linkage of organism to sepsis (if able), etc.
2. Do you list all of your diagnosis for your coders that make a difference or not?
Try to, but this is not always possible/practical. Will definitely list MCCs and CCs, sometimes will capture those codes that make a difference but might not be captured (for example, Glasgow Coma Scale scores).
3. How often do you look at your charts concurrently after admission, including your long stays (ICU)
Great question. Depends on how many new admits and general workload. Kiddos with long stays may get reviewed once per week if able to screen for surgical procedures or obvious MCCs/CCs. I will usually look at the coder's interim summary on long stays and if SOI/ROM is maxed at 4/4 will prioritize reviews accordingly.
4. When coding, do you get your APR-DRG and move on...or do you hold onto your charts until d/c, ICU's and medical charts.
We keep patients on our active list until discharge then reconcile after coding summary is finalized.
Hope this is helpful,
Jackie Touch, MSN, RN, CCMC
CHOC Children's
Steph
-----Original Message-----
From: Pediatric CDI Talk [mailto:pediatric_cdi_talk@hcprotalk.com]
Sent: Wednesday, April 06, 2016 9:38 AM
To: Hill-Sandoval, Stephanie D
Subject: re:[pediatric_cdi_talk] Query burn out
Good morning, Stephanie~
Please see below for responses:
1. How do you prevent query burn out with your doc's, but still be accurate with your queries that do and do not make a difference.
We query for CCs and MCCs off the bat. But, as you know, SOI/ROM makes a huge difference, so my general practice is to query for appropriate diagnoses (presence of indicators, risk factors, treatment) with SOI of 2 or above if it looks like it will move the final SOI/ROM. To try to assist in developing consistent documentation habits, I will also query for linkages of organism with pneumonia (sometimes but not always will impact DRG and/or SOI), linkage of organism to sepsis (if able), etc.
2. Do you list all of your diagnosis for your coders that make a difference or not?
Try to, but this is not always possible/practical. Will definitely list MCCs and CCs, sometimes will capture those codes that make a difference but might not be captured (for example, Glasgow Coma Scale scores).
3. How often do you look at your charts concurrently after admission, including your long stays (ICU) Great question. Depends on how many new admits and general workload. Kiddos with long stays may get reviewed once per week if able to screen for surgical procedures or obvious MCCs/CCs. I will usually look at the coder's interim summary on long stays and if SOI/ROM is maxed at 4/4 will prioritize reviews accordingly.
4. When coding, do you get your APR-DRG and move on...or do you hold onto your charts until d/c, ICU's and medical charts.
We keep patients on our active list until discharge then reconcile after coding summary is finalized.
Hope this is helpful,
Jackie Touch, MSN, RN, CCMC
CHOC Children's
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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 Pediatric CDI Talk as: hillsandovals@email.chop.edu If you would like to be removed from Pediatric CDI Talk, please send a blank email to leave-pediatric_cdi_talk-20307913.232da67f2f645916bbadbb9906bdd6de@hcprotalk.com
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
Varies by CDS (for example, the CDS covering NICU generally has a higher number of established patients due to the long stays, but not as many new admits). I cover PICU, surgical, and med/surg (neuroscience) units and generally have anywhere between 25-35 patients on my list (we do not review all payors-we review about 45-50% of all inpatients). I looked at the last 4-5 months and my average daily number of established patients is 29 (not counting admits). My units average about 8-9 admissions per day (varies between 4/day to 16/day).
Jackie Touch, MSN, RN, CCM
CHOC Children's
jtouch@choc.org