Reconciliation of Final DRG

patricia.fountain@umassmemorial.org

Hello all,

Wondering how many of your CDI teams still reconcile the working DRG with the Final DRG.  What are the advantages and disadvantages of the reconciliation process as far as your experience?  I am interested to know your thoughts on the value of reconciliation, pros and cons, especially if you have reconciled in the past and no longer do. 

Many thanks, appreciate all feedback and insights as our program moves forward.

Patti

justamandakay

We reconcile the working DRG with the Final DRG.  Advantages- assists with CDI reporting.  Disadvantages-time consuming.  I am also interested in thoughts of others that no longer reconcile.

Amanda

evanspx@sutterhealth.org

We reconcile the final DRG in order to ensure reported financial metrics are accurate.  It is time-consuming.

lprescott1

The process of reconciliation is valuable as educational tool. It promotes discussion and sharing. I encourage new CDIS to always participate in reconciliation as this process may identify missed opportunities for the novice to learn as well as to reinforce coding guidelines and AHA Coding Clinic guidance. also these discussions may bring to light to the coder some clinical considerations that they may not have picked up. Of course for this to be a learning opportunity it cannot be contentious or confrontaitional.  

Krepetto

We still reconcile and it is very time consuming, we use it as an educational tool and to facilitate accurate reporting from a departmental and system perspective.  CDI has recently assumed the workflow of sending all queries.  Coders place a case in a work queue after coding prior to bill. CDI sends the queries if they agree there is enough clinical support and follows our policy of query escalation when necessary.  This new process has provided much education for all as well as improved accuracy in  capture of soi/rom and DRG assignment, we have even seen a slight elevation in our CMI.

jackietouch@aol.com

We reconcile accounts reviewed by CDS after final coding and bill drop. Yes, it is very time consuming but provides great educational opportunities as stated. We have encountered cases where collaboration with coding regarding missing or inaccurate PCS codes (ie vent duration) have had positive impact on the DRG weight.

hillsandovals@email.chop.edu

HI we reconcile as well post d/c. I agree it is used as an education al tool for CDI and coders.

Steph

SwartK@upstate.edu

We reconcile, great learning opportunities! I am targeting reconciliation to be handled by second level reviewers proficient in CDI and escalating education needs to staff educator.