functional quadraplegia

dvitalone1dvitalone1
in CDI Talk Archive
Does anyone have a query for functional quadraplegia? Our CDI program is new and this is an area which we want to educate the physicians on. Thanks!

Dawn, RN
CDI Specialist
Community Hospital

Comments

  • robert.hodges2robert.hodges2
    edited April 2016
    This is really good. Thanks for sharing J



    Robert



    Robert S. Hodges, BSN, MSN, RN

    Clinical Documentation Improvement Specialist

    Aleda E. Lutz VAMC

    Mail Code 136

    1500 Weiss Street

    Saginaw MI 48602



    P: 989-497-2500 x13101

    F: 989-321-4912

    E: Robert.Hodges2@va.gov



  • Unknown
    edited April 2016
    Christina;

    In my recollection of the conference, I do not recall much discussion of functional quadrapelgia.

    Thank you


  • dvitalone1dvitalone1
    edited April 2016
    It was discussed in 2 tracks that I attended!




  • dvitalone1dvitalone1
    edited April 2016
    They discussed that the clinical indicators are in the record such as "total care", "total ADL dependent", "contractures", "dementia" but not being documented as functional quadriplegia. Please see Forms and Tools Library under conference materials and go to presentation on "A clinical overview of the CC/MCC List" and "Using the 'Dashboard' to Drive the CDI Process"-see slides 45--47 (I think)


    Dawn M. Vitalone, RN
    Clinical Documentation Improvement Specialist
    Community Hospital




  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    I hope this attaches ok... let me know if it doesn't.

    Katy Good

  • mdomineseymdominesey
    edited April 2016
    Katy, your query has the definition of functional quadriplegia, but it does not address those who may be functionally quadriplegic because of some mental disability though they are not "physically disabled". I was under the impression that functional quadriplegic implies something equal to quadriplegia but it does not have to be because of "physical disability".

    Kindest Regards,

    Mark



    Mark N. Dominesey, RN, BSN, MBA, CCDS
    Sibley Memorial Hospital



  • robert.hodges2robert.hodges2
    This may help as well.

    Robert

    Robert S. Hodges, BSN, MSN, RN, CCDS
    Clinical Documentation Improvement Specialist
    Aleda E. Lutz VAMC
    Mail Code 136
    1500 Weiss Street
    Saginaw MI 48602
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    Mark,
    I struggled with this one. Functional quadriplegia is complex and Dr's are not familiar with this diagnosis (in general). I am limited by space on my queries and didn't want to spend a paragraph explaining it. It is my understanding that dementia is the most common cause but to qualify for functional quadriplegia I would still expect them to be immobile and likely have contractures.
    When I realized we were not capturing this diagnosis I spent a bit of time educating MD's in person. I targeted palliative care and met with their team since they often are on these patients care team. I also circulated the attached tip. At this point, most my hospitalists are familiar enough with the diagnosis that we really just need a "trigger" for them to consider the diagnosis.

    I would be interested in hearing how other CDS's approach this issue.

    Katy Good, RN, BSN
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Office: 928.214.3864
    Cell: 928.814.9404

  • robert.hodges2robert.hodges2
    It's not something I see here very often, but have done education to all the providers on it through my newsletter I sent out every couple of weeks. We have a "Debility/Weakness" query we use when that diagnosis is made and functional quadriplegia is indicated as a potential diagnosis along with many others.

    So basically, I've done the same thing you have Katy. Educate the providers and keep on asking the questions.

    Robert

    Robert S. Hodges, BSN, MSN, RN, CCDS
    Clinical Documentation Improvement Specialist
    Aleda E. Lutz VAMC
    Mail Code 136
    1500 Weiss Street
    Saginaw MI 48602
  • stacy.vaughnstacy.vaughn
    edited April 2016


    Where do you post these tips? email is not always the most effective
    means for us. Just wondering if there are more creative avenues........
    Like on the back of the door in the bathroom stall? :)

    Stacy Vaughn, RHIT, CCS, CCDS
    Data Support Specialist/DRG Assurance
    Aurora Baycare Medical Center
    2845 Greenbrier Rd
    Green Bay, WI 54311
    Phone: (920) 288-8655
    Fax: (920) 288-4235






    CDI Talk
    03/02/2012 09:42 AM
    Please respond to
    cdi_talk@hcprotalk.com


    To
    stacy.vaughn@aurora.org
    cc

    Subject
    RE: [cdi_talk] Functional Quadraplegia






    Mark,
    I struggled with this one. Functional quadriplegia is complex and Dr's are
    not familiar with this diagnosis (in general). I am limited by space on my
    queries and didn't want to spend a paragraph explaining it. It is my
    understanding that dementia is the most common cause but to qualify for
    functional quadriplegia I would still expect them to be immobile and
    likely have contractures.
    When I realized we were not capturing this diagnosis I spent a bit of time
    educating MD's in person. I targeted palliative care and met with their
    team since they often are on these patients care team. I also circulated
    the attached tip. At this point, most my hospitalists are familiar enough
    with the diagnosis that we really just need a "trigger" for them to
    consider the diagnosis.

    I would be interested in hearing how other CDS's approach this issue.

    Katy Good, RN, BSN
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Office: 928.214.3864
    Cell: 928.814.9404

  • jlindseyjlindsey
    edited April 2016
    In the pediatric population, we see Functional Quadriplegia often. We have a large amount of kids with chromosome deletions, mitochondrial disorder and Cerebral Palsy. We direct the query to our Neurologists and they have no problems with the term.

    Jill Lindsey, RN, BSN

    Phoenix Children's Hospital
    Clinical Documentation Specialist
    602-810-4197
    Ext. 3-0725


  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    We put them in dictation rooms, MD lounges, etc. I do email them to MD's who have asked me to but not to the MD's at large. We also routinely pass out tips in department meetings that we attend. We also have a "documentation tips/guidelines" notebook in each dictation room that contains all the tips we have made as well as other documentation/clinical guidelines (CKD staging, top 50 DRG's with GMLOS, etc).
    Also, If I have a Dr that is routinely missing something or documenting incorrectly, I use the tips as a guide and as something I can hand them as a reference. For example, I met with our neurosurgeons to discuss "midline shift" and "mass effect" and bought my "cerebral edema and brain compression" tip to leave with them at their office.
    The hospitalists actually suggest tip topics now.

    Katy Good, RN, BSN
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Office: 928.214.3864
    Cell: 928.814.9404

  • cmclose@saintfrancis.comcmclose@saintfrancis.com
    edited April 2016
    That is still a tough one to get where I work~ "CP" is preferred here. A work in progress :)

    Claudine Hutchinson RN
    Clinical Documentation Improvement Specialist
    Children's Hospital at Saint Francis




  • cmclose@saintfrancis.comcmclose@saintfrancis.com
    edited April 2016
    Katy~ would you mind sharing your Cerebral edema Tip sheet with me (send
    to email below)? I would appreciate it!

    Claudine Hutchinson RN
    Clinical Documentation Improvement Specialist
    Children's Hospital at Saint Francis
    Email: chutchinson@saintfrancis.com
    Office: (918) 502-6603
    Pager: 98-1001

  • jlindseyjlindsey
    edited April 2016
    Claudine,

    Do you have a CP query? We use:

    Non infantile CP
    Paraplegia
    Tetraplegia
    Quadriplegia
    Torsion Dystonia
    Spastic

    Infantile CP
    Diplegia
    Monoplegia
    Hemiplegia
    Quadriplegia

    Works every time!

    Jill Lindsey, RN, BSN

    Phoenix Children's Hospital
    Clinical Documentation Specialist
    602-810-4197
    Ext. 3-0725



  • lsipos@monument.healthlsipos@monument.health
    edited April 2016
    Katy
    This flyer is AWESOME! And yes, Stacy we have actually placed similar flyers on the back of the bathroom doors in the Physician bathroom! LOL. We figured the more we are visible, the better! What better place to put it than somewhere that the physicians are sitting down (:)) and aren't otherwise distracted!
    I can't say it's always well received, but we are just doing our jobs, and if even ONE provider remembers seeing it, then we have done a service to our patients and our institution!
    Juli Bovard RN CDS

  • lsipos@monument.healthlsipos@monument.health
    edited April 2016
    Katy
    Me too..would love to see the cerebral edema tip. That is one we have struggled with lately!
    Juli Bovard RN CDS

    jbovard@regionalhealth.com

  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    Sure!

    Katy Good, RN, BSN
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Office: 928.214.3864
    Cell: 928.814.9404

  • cmclose@saintfrancis.comcmclose@saintfrancis.com
    edited April 2016
    No but may need to create one! Great tip Jill~ thank you!

    Claudine Hutchinson RN
    Clinical Documentation Improvement Specialist
    Children's Hospital at Saint Francis
    Email: chutchinson@saintfrancis.com
    Office: (918) 502-6603
    Pager: 98-1001



  • dvitalone1dvitalone1
    edited April 2016
    Great information! Thank you for sharing! Does anyone have educational flyer/information for the link of HTN and CAD?



  • Unknown
    edited April 2016
    Do you happen to have a tip sheet related to oncology and or cardiology

    IE pancytopenia due to Chemo

    Tracey Carey RN
    Clinical Documentation Specialist
    UAMS
    686-7421
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, March 02, 2012 10:36 AM
    To: Carey, Tracey T
    Subject: RE: [cdi_talk] Functional Quadraplegia

    Sure!

    Katy Good, RN, BSN
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Office: 928.214.3864
    Cell: 928.814.9404

  • jlindseyjlindsey
    edited April 2016
    Hi Tracey,

    We don't have tip sheets yet. We are working on getting some started. Our Medical Director is one of the Hospitalists so she is our walking tip sheet for now!!!

    Jill Lindsey, RN, BSN

    Phoenix Children's Hospital
    Clinical Documentation Specialist
    602-810-4197
    Ext. 3-0725

  • judithbatesjudithbates
    edited April 2016
    Great queries from both you and Bob...I'll be making up my own as this is something we have not been querying for...
    THANKS!

    Judi Bates RN, BSN, CCDS
    Our Lady of Lourdes Medical Center
    CDI Specialist
    856-757-3161
    Beeper 66x2906
  • sthomas7sthomas7
    edited April 2016
    If the patient is documented to be able to move their arms, that could imply that they can feed themselves and participate in hygiene; I would not query for functional quadriplegia in that case. There is a great article on ACP hospitalist that we like to reference when we query for that diagnosis, both to educate the physicians and refresh ourselves when we query. In case you haven't seen it, here's the link:
    http://www.acphospitalist.org/archives/2012/05/coding.htm

    Hope that's helpful :)

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