Outpatient CDI - E/M focus

robbimorris@sheridanhospital.org

Has anyone here started an outpatient CDI program with an E/M focus?  I am struggling to find resources to call on.  I have found a lot of teaching material, and have had some education on E/M.  I am curious about how all of this breaks down in the day to day routine.  Is it only observe, run reports and educate?  Or is there a way to review, query, etc.  I am interested in any details anyone is willing to share. 

Thanks!!

janinepodany@yahoo.com

Our facility is wanting to start an CDI review in ER and orthopedics focused on E/M coding.  I have no insight at this point, but would like to follow this thread.

Rebekah.Wood1

We just implemented a program in our geropsychiatry unit specifically looking at Chief Complaint (missing often which leads to no E&M for that note) and ensuring in the Assessment and Plan area that we have a plan with each diagnosis for HCC capture and depending on the plan with the dx can affect the E&M level. We are able to enter our queries in 3M 360 for tracking, but still have an excel spreadsheet to determine what the E&M level would have been and what it is after we sent a query to the provider...this is all done concurrently.

m1ghtymurs3

I have been looking into E/M coding for CDI as well, has anybody made any progress with this? 

agreathouse

I did auditing, by provider , annually for out patient e/m only. Looking at visits for primary care in nursing homes, skilled care, home and assisted living. I had a metric card based on office visit coding that allowed the provider to know what I was looking for prior to submitting their claims/superbill. If they were unsure of a selection, they could contact me for a concurrent review before signing it. I used denials as the tool for education and trending for changes to how they were documenting. I just changed positions and am starting an out patient coding program for a hospital system and hope to use some of this in my new position, but in a larger scale and start small with where we implement to get an idea of how to grow the whole project.

NancyTC

I am starting a new outpatient CDI program at my medical center, focusing on our primary care practices.
I would appreciate any insights and resources that those who are already doing OP CDI would be willing to share.  I am particularly looking for an EMR audit tool that includes E/M level, Problem List, and HCC capture.  

ABWhiteRN

I started an OP CDI program in our Primary Care Practices last January.  I focus on the Medicare RAF Score Report and conduct retrospective reviews based on MCR ACO patient population.  I follow the same time period as the report and look for additional coding opportunities.  Once I have 30 charts reviewed, I meet with each individual provider to discuss their findings.  I am very impressed by the level of provider interest and engagement.  I developed tools with the most commonly missed diagnoses as reminders when they are documenting.  Email me if you would like more information.  alison.white@cvmc.org.