query compliance & physician advisors
I have been studying for the CCDS and the 2019 updated Physician Query Practice Brief has some great information that has led me to present at the CDI-Coding meeting. I have also been requested to share with other groups, and recently just shared with case management. There is one burning question that seems to be controversial at our facility. The Brief states in summary, no matter the role, title, etc.....all healthcare professionals must comply with the brief if their conversations impact claims data. A few members of our executive team feel that when our physician advisors speak with providers regarding documentation that somehow they are exempt from the query compliance. I can understand provider that have direct patient care can discuss diagnoses freely among themselves and would think expected. However, my interpretation of the brief is that any healthcare provider, physician or not, needs to be compliant in conversations if it impacts documentation. The brief does not specifically address provider to provider (one being a physician advisor) conversations. Can someone help me out? Are physicians exempt? If not, how do I convince our executive team? Thanks!!
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Paul Evans, RHIA, CCDS