Verbal queries

Hello all,

I did a search but did not find anything about verbal queries. Wondering how you track these? How do you audit query compliance? Thanks for any and all processes that you follow.

Ronna Mahlen, RN, BSN, C-CDS
Valley Medical Center
Renton, WA 98055
425-228-3440 x 3610

Comments

  • edited May 2016
    Even our verbal queries are written down and logged so they can be tracked. It was determined that if we had to write out the verbal query, it kept us in compliance.

    Sharon Cole, RN, CCDS
    Case Management
    254.751.4256
    srcole@phn-waco.org
  • edited May 2016
    We require:

    "Verbal queries will have a written summary recorded of the conversation as soon as practical following the query"
    "Verbal queries are acceptable and may either be the result of a fortuitous encounter with the attending (where the written query was already submitted but not viewed) or may be a result of attempting to obtain an answer to a written query where the medical staff had not yet responded"
    The intent is that the written summary of the verbal query is recorded and stored in the same manner as the written query. The content should also be the same (ie, include the clinical indicators / documentation quotes discussed, the question & options posed and the physician's response to the question).

    With this type of documentation, allows essentially the same audit process and standards to be applied.

    Don
  • edited May 2016
    We treat it as a regular query and actually complete a paper query which is entered into our system. If the Dr. Answers "favorably" and documents within the chart we enter it into our spreadsheet as $$ we can count.
  • edited May 2016
    We use CDIS by 3M which tracks all our queries in whatever form. That
    said, frequently our verbal queries are stemming from an original
    written query. Either way, our clinical findings, what prompted the
    query is typed in to the program as the basis for the query. The report
    I run will identify what form the query was in for tally.

    Donna

    Donna Kent, RN, BSN, CCDS
    Manager, Clinical Documentation Integrity Program
    Clinical Quality and Accreditation
    Torrance Memorial Medical Center
    ph.:310 784-6884 fax:310 784-6899
    donna.kent@tmmc.com
  • edited May 2016
    What I find interesting is the threads of this blog fail to mention any physician education component. Instead the thrust of the discussion is upon insuring the CDI records the results of the query as well as the increase in $$. This is problematic from a continuity of clinical documentation standpoint and plays into the grab the diagnosis, record the "win" and move to the next chart in an effort to capture the next win. This is type of CDI focus plays right into the hands of the RAC, CERT, and MACs who all perform retrospective and prepayment audits. CDI improvement initiatives undoubtedly contribute to unnecessary denials.

    Remember mission and purpose over business as usual...
  • edited May 2016
    We also track all of our queries no matter how they are sent. In fact our policy also says that if verbal queries are used they must follow the verbiage used in the written queries to avoid them being leading in nature.

    Robert

    Robert S. Hodges, BSN, MSN, RN, CCDS
    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
     
    "We are dealing with Veterans, not procedures; With their problems, not ours." --General Omar Bradley
  • edited May 2016
    While the majority of us agree with you Glenn, and your position is sound, we who directly work for hospitals have to be mindful of our impact, not just on quality of the documentation, but also to the hospital's bottom line. It would be naïve to believe that hospitals start and sustain CDI programs merely for the potential to increase documentation quality.

    Most of us do not need lecturing, but the kind, supportive language of your articles and blog postings.

    Thanks for the reminder about the overall purpose of CDI.

    Mark N. Dominesey, RN, BSN, MBA, CCDS
  • edited May 2016
    I agree w/what you posted for the most part- except for the implication that programs are just doing this for the $$ and "win".

    We want a complete and thoroughly documented medical reecord. However, there must be some accountability of work and productvity. And for those who count the $$ and give us additional positions, $$ for educational resources, we can show them how we have impacted the bottom line as an additional perk. And this done by simply asking - compliantly - to document what is already present in the chart and being treated.

    NBrunson, RHIA,CCDS
  • edited May 2016
    In part, because there is only so much data that can be manually tracked
    and accounted for. Beyond a certain point, the reliability of data
    collection is going to suffer. (As a complete data geek, I continually
    need to be reminded by my staff to KISS -- keep it simple -- and we then
    tend to get key data accurately).

    The data I report up to executives does reflect non-financial activity
    of our group. In addition, I have explicitly included expectations
    about formal and informal education with providers as part of the matrix
    which drives CDS evaluations.

    Also, the simple process of discussing what the issue is (about the
    documentation vs clinical picture) inherently involved education and I
    presume that as a background factor for any verbal query. But as was
    pointed out, there is not an active accounting of physician education.

    (I do intend on replying to the blog posting from Glenn, but as well
    done as that post was, I want to put up a thoughtful response.)

    Don
  • Education is a large component of our program as we present education regarding specificity and the need for accurate data on a continual basis - I have PowerPoint Presentations devoted entirely to MD education. None of these mention the financial aspects of CDI.

    However, given any coding system 'rewards' more specific coding, we have found that improvement in our O/E ratios is logically accompanied by valid increase in our CMI. This is inevitable.


    Each query form we use cites 'evidence-based' criteria (example: Surviving Sepsis) as a permanent part of the record, and we ask the MD to determine if the MD-approved criteria is met, not met, unable to determine, some other condition, and so forth.

    Therefore, I do believe such query forms serve to educate the staff in regards to terminology, documentation, coding, Core Measures, O/E, and so forth.

    However, it is not practice to educate a particular MD each time we leave a query in a chart - but, I believe our process is 'educational'. As Don stated, we would all appreciate data, but entering data has costs - at this time, we have 2.9 FTE for over 1,000 beds, and we are very strategic in how we focus our efforts.

    Paul Evans, RHIA, CCS, CCS-P
    Supervisor, Clinical Documentation Integrity, Quality Department
    California Pacific Medical Center
    2351 Clay #243
    San Francisco, CA 94115
    Cell: 415.637.9002
    Fax: 415.600.1325
    Ofc: 415.600.3739
  • edited May 2016
    We do quite a few verbal queries. The physician must document the requested information in the medical record or it cannot be used. We are an entirely electronic medical record so we do not use paper queries. Our queries are either done electronically or verbally. Our queries are not part of the medical record.
    Cindy
  • edited May 2016
    The issue could be discussed verbally, but would have to be documented in the medical record for the coders to code it.

    Carmella
  • edited May 2016
    I do verbal queries all the time and log them as I do any other query, but our queries are not part of the patient record. Providers must document them in their notes for the response to count here.



    Robert



    Robert S. Hodges, BSN, MSN, RN, CCDS
    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



    “Patriotism is easy to understand in America; it means looking out for yourself by looking out for your country" Calvin Coolidge

    We started a new process about a week ago with our Hospitalist group. The Director of Case Management and I meet with the hospitalists on service each morning to discuss each patients case and the plan, etc.. My boss and Director of Medical Records periodically sits in on these meetings. Today she was present and asked if I logged verbal queries for each of the patients I discussed with the hospitalist in regards to clinical documentation improvement, clarification, etc. Currently I would just log it in our CDI program as a verbal query. Does anyone currently log verbal queries in a query form by stating what was discussed and the physicians response being documented by myself per the physician (rather than the physician choosing an answer by placing an X, (like the written queries) and then have the physician electronically sign it? We are currently paperless with all of our queries. How does one go about capturing this information, without then querying the physician again for the information and at the same time remain compliant with the AHIMA guidelines for a query?

    (EX:: Physician stated the patient had CHF exacerbation with Pulmonary Edema. I asked the physician for the acuity and he said it was Acute. How do I capture this increased specificity if it is not currently documented, but the physician specified the acuity verbally? Thank you!
  • edited May 2016
    Our queries are a part of the medical record and all queries are documented in a written form, whether presented as verbal, paper, or electronic.




    Charlene Thiry RN, BSN, CPC, CCDS
    Clinical Documentation Specialist
    Quality Resources
    Menorah Medical Center
  • edited May 2016
    Just an FYI, Exacerbation - if documented - is considered Acute CHF. So is Decompensated.

    We are hybrid so we have in the past actually made up a Verbal Query form and entered the query into our software making sure we documented that a verbal query was given and thus and such was the answer.

    As of late we only enter it into the software with a note of clarification.

    Is there a way you could issue the query electronically but not actually assigned it to the physician? Is there a deficiency assigned when you issue electronically? If there is a way to issue but not count against the physician that may be an option. I would make sure you have a policy/procedure in place.

    Or...there's always the Spreadsheet...

    N.Brunson, RHIA,CDIP,CCDS
  • edited May 2016
    We are electronic also. Our queries are not part of the legal medical record but a business record. Verbal queries are documented in our CDI system and we capture the results of the query there. The physician must document the response in the legal medical record for it to count as answered.
    Shelia
  • edited May 2016
    Definitely get the Diagnosis documented in the chart! :)

    NTB
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