Seziures- epilepsy monitoring unit
I have a meeting coming up with our neurologists regarding documentation in the EMU (epilepsy monitoring unit). They are wanting to make sure that they are documenting appropriately and that we are not missing any opportunities. We are on MS- DRG's so I am not finding that there is really a lot of opportunity within DRG 101. Please let me know if any of you have had any luck with this or if you can offer any suggestions.
Thank you!
Leah Savage, RN, MSN, CCDS
Kosair Children's Hospital
Louisville, KY
leah.savage@nortonhealthcare.org
Comments
Hi, Leah~
Yes, you are right: Not much opportunity in DRG 101. But, severity is impacted by specifying intractable versus not intractable and is sometimes impacted by degree of intellectual disability (severe or profound). The most common MCCs I have clarified for in our EMU population are spastic quadriplegic cerebral palsy or brain malformations (absence of corpus callosum, holoprosencephaly, lissencephaly, etc). We always screen for any indicators of severe malnutrition in this population also.
Re: use of encephalopathy as an MCC on these patients-we generally do NOT capture encephalopathy if it documented as "static" encephalopathy, as this implies a chronic, nonprogressive state that will not improve. If, however, the child has indicators and risk factors for hypoxic or anoxic encephalopathy, we will clarify for it. Does not give you an MCC, but does impact SOI/ROM.
Hope this helps,
Jackie Touch, MSN, RN, CCM
CHOC Children's, Orange, CA
Hi Leah, I agree with Jackie...many times those EMU patients have cc's and mcc's as co morbid conditions. Now, we do have some that just come in for EMU to rule out, etc... and there's not much you can do with those. It all depends on your population, we have about 50/50 chronic kids vs. new dx, etc..
Jeff
University of South Alabama Children's and Women's
Thanks so much! That is all really helpful. We have a lot of rule out kids as well, so I know we will need to maximize what we can on the chronic kids.
Leah