Definition of a great program

Cayleb

My facility feels that the program is not beneficial if the Cdi 
DRG and the coders DRG does not match. they also feel
that only if the Cdi cc or mcc is the only code making a difference only then is our work making an impact. Any thoughts would be appreciated.

ttrombley@ghrrevcycle.com

It sounds as though your facility may need further education regarding the benefits of a clinical documentation improvement program.  Once upon a time, that is how many CDI programs may have been measured, - for DRG impact only.   But that is only 1 by-product of clear consistent and accurate medical record documentation.  We now know that there are many benefits to accurate medical record documentation, such as improved quality measures, improved Observed to Expected ratios, accurate risk of mortality scores, accurate severity of illness scores that impact APR DRGS as well as many quality risk models.  The list goes on and on. Now we have CMS-HCC and HHS-HCC risk models that are also impacted by accurate documentation and coding.  I hope the impact of your queries that are not DRG impact are appreciated for the numerous reasons I just listed.  Good luck to you.  

lprescott1

Do you demonstrate a query rate and query impact measure. your work concurrently is what leads to the coder determining the final DRG. I would also add that the work CDI performs concurrently should lead to a shorter billing cycle as your clarifications allow the coder to code the record without further query- meaning the account is billed more quickly. 

and as ttrombley said- the list goes on an on- quality, risk adjustment, complication rates, mortality etc.