SOI/ROM - how do you capture and get credit for these clarifications

I am reaching out to see what other facilities are doing with clarifications that are not a CC/MCC impact. I use the 3M Encompass software and the SOI/ROM is calculated during the CDI review. All codes have a value attached as SOI/ROM however, the final numbers reported have a specific formula (which I do not know) and not all codes impact the final number.

With ICD-10 specificity - many clarification may impact only the final SOI/ROM - reporting a higher acuity of patients conditions.

Do you include this type of clarification in metrics? How do you measure the impact? Does your program get credit for the clarifications?

any advice is appreciated


  • Does your software hold initial SOI and ROM, similar to the working DRG? We compare pre- and post-query SOI and ROM and are calculating monthly and yearly averages per facility and per service. This is included in our metrics, and we educated the leadership on the importance of it. SOI and ROM statistics can provide valuable insights on the complexity of your patient population and give you an idea on whether your education is working. If it is, you will see your initial SOI and ROM trending up over the time, meaning that your providers are documenting better. This might serve a good justification when the number of queries and money impact flattens since you do not have to seek clarifications as often.
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