Impact of Observation CDI

proddy@clarionhospital.org

I am wondering what achieves the most impact for CDI in reviewing observation cases (other than potential obs to inpt admissions).  The typical things like specificity of diagnoses (CHF, Pneumonia, CKD,etc) and capturing morbid obesity, etc.  If this patient never becomes an inpt, how much impact is there for payment?  How much overall impact for other measures like risk adjustments, HCC's, etc?

lprescott1

Interesting question and one I would enjoy hearing more from those who are working this process. I have heard (completely not scientifically) that most people who review observation records to assist with converting to inpatient do not see great impact. But I have spoken to many who review the observation records with a goal of charge capture- assuring documentation assists with medical necessity for ordered tests/treatments, and clarifying any discrepancies related to time and hour counts etc. 

bmurphy@hcpro.com

A couple links to resources on the ACDIS site you might find helpful:

https://acdis.org/resources/2017-conference-day-3-track-5-new-documentation-frontier-expanding-cdi-outpatient

https://acdis.org/articles/radio-recap-expanding-cdi-outpatient-observation-setting