Do your coders query?
It has been proposed that CDI take over all the query management process for our institution. This would add an average of 17 additional queries per month per CDS with a potential loss of 8 hours per CDS in overall productivity due to managing the query development and resolution process . The average monthly query volume for our facility is 250 queries.
Does any other facility direct all their query management through CDI? If so,
What is your facility size?
What is your average query volume?
What is your expected productivity standards per CDS?
Any additional information would be appreciated.
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Comments
Yes, my department (CDI) sends all the queries. It has been a great success!
Lee Health- over 1400 beds (5 hospitals) Last month we sent around 2300 queries total.
I have 2 dedicated staff members that work a WQ for coding query requests. If the WQ has no requests, they do Initial reviews. I don't have productivity standards for this workflow because it varies so much (having the right people in that position makes all the difference).
This process outweighs the loss of productivity in my department.
Pros:
At my last facility we requested that CDI perform ALL query duties. This was mainly for consistency. We could ensure all queries were developed in a similar fashion and we could follow-up with providers more easily since we had better access to the docs than the coders did. Like Jill mentioned, we also cut out a fairly significant portion of the queries (this generally did require some discussion with coding/CDI). The other reason to implement this kind of process is that its great education for CDI as they see what they potentially missed during the concurrent process and it encourages them to be proactive since they will be responsible for post-discharge queries if they choose not to query on something that they should have.
I don't have the numbers you're requesting but we felt the impact was minimal. That being said, we were already doing all-patient review so coding queries were routed back to the concurrent CDI who should already be familiar with the case.
Katy
This is a very interesting process and could be very effective! Are there times when a coder wants to query but the CDI feels that the query is uneccesary? How is that process mediated?
There absolutely are those times! this is one of the really great things about the process because it allows bilateral transfer of knowledge. CDI's learned about opportunities they were missing and Coders learned from the CDI's as well. We had situations where coding thought a query was necessary but CDI did not on a fairly regular basis. Most of the time the coder and CDI could resolve these issues independently. If they needed a second opinion, they would reach out to myself and, sometimes, the coding manager.
Also, often the coder really just wanted a 2nd opinion/reassurance from another person. This created a process for them to get that because they could easily ask the CDI if they thought a query was warranted. Overall, this promoted discussion and collaboration.
Katy