CDI program associated with Health Information

Unknown
in CDI Talk Archive
I know I have seen this posed on this forum many times. Due to recent developments, I would like to know how many Clinical Documentation Integrity programs are affiliated with Medical Information or Health Information Management.

I would also like to know from the gurus that be-- is it better to be affiliated with Health Information or Outcomes Management? I feel it is better to be affiliated with Health Information so that the RN Documentation Specialists can work with the coders to assure the documentation in the medical record is clear and concise for all diagnoses in the medical record. Our program here not only looks to capture CC's and MCC's but we are trying to obtain clear and concise documentation in the medical record for all diagnoses documented. We feel this protects us against RAC audits, quality issues and other areas as well.

Please render your opinion.


Juanita B. Seel, RN
Supervisor Clinical Documentation Integrity
Greenville Memorial Hosptial
Greenville, SC
864-455-4981

Comments

  • dallend@einstein.edudallend@einstein.edu
    edited May 2016
    We are in HIM. I think it is better to be affiliated with HIM since it give CDI the opportunity to work with the coders to ensure that we have as clean a chart as possible.


  • robert.hodges2robert.hodges2
    edited May 2016
    I agree. I’m a direct report to the Chief of HIM and at the same level as the lead Coder. The advantage is we talk over issues together and learn from each other’s expertise.



    Robert



    Robert S. Hodges, BSN, MSN, RN

    Clinical Documentation Improvement Specialist

    Aleda E. Lutz VAMC

    Mail Code 136

    1500 Weiss Street

    Saginaw MI 48602



    P: 989-497-2500 x13101

    F: 989-321-4912

    E: Robert.Hodges2@va.gov




  • mark.domineseymark.dominesey
    edited May 2016
    I am also associated with HIM. I see the direct benefit of collaboration with coders and HIM is a logical place to be to foster that collaboration.

    Mark








  • Unknown
    edited May 2016
    My home department is Quality. I reside with the coders and interact with them on a day to day basis. The thrust of our Documentation Integrity Program in accurate SOI/ROM. MCC/CC capture has never been the issue. HIM focus has been more toward 'if we have the MCC/CC, drop the bill'.

    This has changed somewhat with the Documentation Integrity Program. Both sides have learned quite a bit from each other from working together yet being in separate departments. It has worked out quite well - residing with HIM but under different leadership. Helps keep the focus for the documentation program on complete documentation. The other issues HIM deals with do not alter the program.

    I believe different styles of management would affect the documentation specialist's role in either setting.

    Charlene


  • ggoodman@virginiahospitalcenter.comggoodman@virginiahospitalcenter.com
    edited May 2016
    Our program is in HIM too. The manager of the CDI program is also the manager of the Coding staff. So it works out well for us as far as collaborating with coders, etc.


  • davisd2davisd2
    edited May 2016
    Our home is Quality. We are a small hospital and work with the coders on a daily basis. Our HIM Director reports to the Director of Quality as do we. Our focus is integrity as well as capture cc and mcc's. We also have monthly meeting with the coders and both Directors to ensure we are all on the same track.


    Denise Davis RN
    Clinical Documentation Specialist
    Quality Management
    Sonora Regional Medical Center
    1000 Greenley Rd Sonora Ca 95370
    209-536-3290
    davisd2@ah.org



  • Unknown
    We are housed within and report to HIM.

    I prefer this setup as we have direct link to Coding Department and our focus is entirely upon documentation.

    NBrunson,RHIA, CCDS
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