Auditing of CDIS

sheila.voisard@waynehealthcare.orgsheila.voisard@waynehealthcare.org
in CDI Management

Does anyone have a company that comes in and audits your CDIS team?  If so what company do you have do this?   We are having a lot of mismatches I want to get to the bottom of the problem and get this rectified as soon as possible.  Thank you in advance for your assistance. 

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Comments

  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu

    We do not use a company for CDI audits, but I try to go through the DRG mismatches and look at the ones caused by coding guidelines, etc.. there's nothing you can do about subsequent documentation or op note available after CDI review but the ones based on guidelines and coding clinics, etc.. are ones that you can tailor education for the CDI's.

    Jeff

  • stargazer_stg@yahoo.comstargazer_stg@yahoo.com
    In our department,  we rectify our mismatches weekly per CDIS. It's a good learning experiencefor CDIS and coder. 
  • sheila.voisard@waynehealthcare.orgsheila.voisard@waynehealthcare.org

    Thanks everyone.


  • wendy.chenney@uhhospitals.orgwendy.chenney@uhhospitals.org

    How do you preform CDIS audits? Concurrently or retrospective? Do you use scoring?

    Thanks, Wendy

    wendy.chenney@uhhospitals.org

  • rdbrayrdbray

    I'm curious as to what criteria is utilized in auditing CDIS? How are you able to determine an accuracy rate and appropriate quality type reviews? When there are several people reviewing records, you can get several different reviews and outcomes. So, wouldn't an accuracy quality type review be subjective?

    Our facility does mismatches/reconciliations between CDIS and Coders on a daily basis. It provides educational opportunities for both parties, related to clinical components and coding guidance.

    We do not submit claims to billing till all DRGs (MS & APR) and SOI/ROM match between CDIS and Coder, even if there has been subsequent documentation causing mismatch. This does not impact our DNB or cause rebill issues.

    Also, as part of the mismatch/reconciliation process, we have an escalation process if an agreement between CDIS and Coder does not occur. The disagreement is escalated to Coding and CDI leadership for review and determination.

    Thanks,

    Dan

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