ACDIS Radio poll on DRG validation... where do you stand?
In case you missed yesterday's ACDIS Radio program we polled our audience (more than 550 dialed in) on the following question and received the following responses:
Does your CDI department perform DRG validation?
• Yes, CDI staff holds final responsibility: 7%
• Yes, in conjunction with HIM/coding: 59%
• No, this is an HIM/coding function: 18%
• We don’t validate DRGs: 14%
• Not applicable: 3%
Where do you stand on DRG validation--CDI ownership, coding ownership, both? Or is DRG validation getting "dated"?
By the way ACDIS Radio is free with registration; if you're not listening sign up here:
https://acdis.org/acdis-radio
Does your CDI department perform DRG validation?
• Yes, CDI staff holds final responsibility: 7%
• Yes, in conjunction with HIM/coding: 59%
• No, this is an HIM/coding function: 18%
• We don’t validate DRGs: 14%
• Not applicable: 3%
Where do you stand on DRG validation--CDI ownership, coding ownership, both? Or is DRG validation getting "dated"?
By the way ACDIS Radio is free with registration; if you're not listening sign up here:
https://acdis.org/acdis-radio
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Comments
I'd opine the CDI should be partner with HIM in order to 'validate' key diagnoses, but I'd caution that DRG assignment involves more than just validation of any diagnoses. Coding is extremely complicated, subject to a great number of complex and often counter-intuitive 'rules' which must be followed in order to compliantly bill. it literally takes years to become a competent coder.
PCS coding can be very difficult, also impacting DRG assignment. I believe CDI teams should be selectively engaged in a strategic manner; but, as one that has managed both HIM Coding teams and CDI teams, I would not want to be accountable, as a CDS, for the final decisions made by coding, such as DRG Assignment. So, part of my issue may be with the wording..Does your CDI department perform DRG validation?
DRG validation - no, not in the domain of CDI teams. However, validation of key diagnoses, yes, in the domain of CDI Teams, acknowledging that vetting of key conditions often impacts final DRG assignment.
Paul Evans, RHIA, CCDS