Query Process Question #2...

I'm interested in how others handle queries generated by another CDS that either move to your floor, or was generated on the weekend by the weekend cover person, or was generated by someone who was covering for someone on vacation.

Scenario -

CDS covers all assignments on weekends. Reviews all admissions, generated Queries on all floors.

CDS comes in on Monday to review their assignment, reviews queries (*which are not a permanent part of the chart*) initiated by weekend CDS - and finds that MD has documented his response on the query - not in the record where it should be documented.

CDS which covers that assignment initiates another query - in additiont to the one on the chart - reminding MD documentation should be made within the Medical Record. Physician then makes documenation within the record, coder codes the chart with documentation.

- For those who do weekend coverage, do you follow the queries you initiated to other floors? Or do you let the Assigned CDS follow the query when they return?

- How do you credit queries?

- If another CDS assists in some way to get your query answered do you both share in the credit - for statistical purposes? (in the example above - if the CDS had not reminded the physician that the query was not a permanent part of the chart and the docuementation needed to be made within the chart - the coder would not have been able to code the information and the query would have been "mute".)

Another example might be when reviewing a concurrent record on a chart which had a query generated by another CDS - which had no response - and calling the physician's attention to the query resulting in him documenting the information.

Thank you in advance for your wisdom and experience.

N. Brunson, RHIA, CCDS

Comments

  • edited May 2016
    The CDS that initiated the query originally gets the credit @ our hospital. Thx


  • edited May 2016
    We try to be supportive in the query process. If a patient moves from one unit to another, we follow the query and the original author gets the credit. To me, the author took the time to write the query and deserves the credit and when the patient moves, I need to take the time to follow up. It's a team effort to the goal.

    Judi Bates RN, BSN, CCDS
    CDI Specialist
    856-757-3161
    Beeper 66x2906

  • Us too! We follow up our team members queries.
    AMY


  • edited May 2016
    When our program started 9 years ago, we were floor specific and as a pt transferred to another floor they were picked up by the CDS on that floor. If there was a query, whichever CDS initiated the query got the credit. If no query but a change in DRG for whatever reason (CC/MCC found, surgery etc) the CDS who made the change got credit.

    Now that we are not floor specific, we follow thru out house as pt travels.



    Karen McKaig, BSN, RN, CCM, CPUR
    Case Manager
    Clinical Documentation Specialist
    Baxter Regional Medical Center
    Mountain Home, AR 72653
    870-508-1499
    kmckaig@baxterregional.org



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