HIM concurrent coder and RN CDI partering

At Emory, we are considering a pilot - concurrent coding (by coder) and CDI partnering. I have scanned the literature and am not finding much. I found the blog by Deanna and Erica, which was very helpful. Does anyone else have experience with this or can share literature?? Thanks! Bonnie

Comments

  • I've had the experience of working with a partner in coding.  When I first started in CDI I worked at the heart hospital which is one of five hospitals in our network.  I was the only CDI RN there and there is also a dedicated coder for that site.  We worked together so well-- I was able to run a chart by her if I had any question as to whether or not the existing documentation was adequate.  Our denial rate was very low. I truly think this is the best way to practice and hope to extend this to our larger coding and CDI teams in the future.  Feel free to contact me if you'd like to discuss in greater detail. 
  • We perform concurrent coding whenever the CDI identifies a HAC or PSI.  The coder will code that chart in order to determine if the codes will indeed trigger a HAC or PSI.  Sometimes CDI doesn't apply the right codes and that might be the one thing pulling into the HAC / PSI.. The coders can also instruct CDI when to query.  It's a work in progress as the coders don't feel as comfortable coding something in real time.  When they see suspected PE, treating for PE they tend to want to wait to see if it gets ruled out (later) before they code it. 
  • I have seen some organizations use concurrent coding to code procedures- thus post discharge the procedural codes were all complete- and coded by a coder- they could code diagnoses and be done. If the concurrent coders need to query the task of query was shared with CDIs. If there no procedures in line to be coded the concurrent coders returned to retro process. this allowed fast turn around of surgical charts, and did not slow CDI concurrent review related to PCS codes. 
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