Keeping current with CDI education without an Educator Role

jlprinz@att.net

In an effort to keep up to date with changes in coding clinics, conventions ect., what avenue works best? As a CDE system we are receiving very little information from the coding dept on trends , audits ect. We tend to find out this important information after the fact with opportunities missed or by doing reconciliation of coding worksheets. Any direction shared will be very helpful in carving a path to the information.

Thank you -

jnoller2072

If your CDI department is separate from the Coding Department, HIM, or however your organization is set up, it is still important to have a good, working relationship with the Coding area so that information -sharing can flower.  Both areas have much to learn from the other. Maybe there is a 'Lead' person in each area who can facilitate conversations, meetings, presentations that both areas can attend and get a dialogue going. 

Just a few ideas.

Janice Noller

jlprinz@att.net

Thank you for your insite. We have a lot of work to do in this arena. We have a CDS/Coder bi-monthly meeting. All of the system sister facilities participate- it is a conference call. It has not proven to be very fruitful thus far. We do ask questions about specific coding issues - We get direction as in -- this is how we will code this. There does not seem to be an avenue  to question or  validate the decisions made. We are not empowered to seek clarity. I am trying to find a means to put a resource in place .

Have a great day !   

proddy@clarionhospital.org

Do you have a reconciliation policy between CDI and the coders? The policy we developed includes reconciliation and agreement between CDI and coding for any changes the coder would make that affects the  DRG, primary diagnosis, any addition or taking away of CC or MCC and present on admission indicators.  So there is agreement before the chart is billed.

jlprinz@att.net

We do have a similar  recon process. However - HIM has the final impact decision. The why and the how are pieces missing. More work to be done

morris-jeff@CooperHealth.edu

As the Supervisor, I try to stay abreast to new Coding Clinics, etc.. but as professionals, the staff are also encouraged to stay current in their profession and share information and ideas with co-workers. We have monthly Coder/CDI collaboration meetings where we discuss guidelines, changes, tough cases, etc.. and the CDI and Coder do have a DRG mismatch procedure (it's informal).

Thanks,

Jeff

jackietouch@aol.com

proddy@clarionhospital.org said:

Do you have a reconciliation policy between CDI and the coders? The policy we developed includes reconciliation and agreement between CDI and coding for any changes the coder would make that affects the  DRG, primary diagnosis, any addition or taking away of CC or MCC and present on admission indicators.  So there is agreement before the chart is billed.

We have a reconciliation process that is completed after the coding summary is finalized by coder and the bill is dropped. If there is a mismatch and the CDS would like the coder to re-review, the CDS communicates 1:1 with the coder to discuss. This is a valuable educational opportunity for both the CDS and coder. If the coder and CDS still disagree after discussion, the CDS will usually request a third party review by our coding auditor (outside contractor) and/or the coding manager. This process has not, to my knowledge, been formalized in a written policy/procedure, rather is our general practice.

We are still working on collaborative education including both coding and CDI professionals. Fortunately, we are in the same department (although we do report to different managers) and we do not have any staff in a formal educator role for the department. The coders do have an outside auditor who reviews their work and provides feedback.

Jackie Touch