"anti" query

I wonder if some may have input to thoughts of an "anti" query...i.e. dx of AKI / acute renal failure. Is it okay to say/ write on the query, that the lab values do not support or meet the criteria for coding acute renal failure? Sometimes I wonder if it is "leading" ? or just stating the facts ?. (especially when the documentation reflects that the creatinine level is related to dehydration) then they are asked for clarification.

How do others approach an "anti" query with physicians? Especially when it is well documented throughout the medical record.

The physician has the ability to answer AKI without failure, hemoconcentration of dehydration, azotemia, acute renal failure or other.

TGIF!! :)


Lona McNamara RN, BSN, CCM
CDIS, Cortland Regional Medical Center
lmcnamara@cortlandregional.org

Comments

  • Hi Lona,

    I don't think it's leading. Below is a query I use for an "anti" query.


    Your assistance with confirmation of a documented diagnosis is requested.

    Diagnosis: ___________________is documented in the ________________. It doesn't appear from documentation that patient meets criteria for _______________.

    Would you please confirm and provide any additional relevant information to further support the diagnosis in the patient medical record.

    1. This diagnosis is not confirmed and/or has been ruled out.

    2. This diagnosis is confirmed.

    Please document your clinical rationale_____________________________.



    Paula Scheiderich, RHIT
    Clinical Documentation Specialist
    Oneida Healthcare
    315 363-6000 Ext. 1084
    pscheiderich@oneidahealthcare.org


    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 8:32 AM
    To: Scheiderich, Paula
    Subject: [cdi_talk] "anti" query

    I wonder if some may have input to thoughts of an "anti" query...i.e. dx of AKI / acute renal failure. Is it okay to say/ write on the query, that the lab values do not support or meet the criteria for coding acute renal failure? Sometimes I wonder if it is "leading" ? or just stating the facts ?. (especially when the documentation reflects that the creatinine level is related to dehydration) then they are asked for clarification.

    How do others approach an "anti" query with physicians? Especially when it is well documented throughout the medical record.

    The physician has the ability to answer AKI without failure, hemoconcentration of dehydration, azotemia, acute renal failure or other.

    TGIF!! :)


    Lona McNamara RN, BSN, CCM
    CDIS, Cortland Regional Medical Center
    lmcnamara@cortlandregional.org





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    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923

    ________________________________
    The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for the use of the person(s) named above. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message.
  • Hi Lona,
    At the last hospital I worked at, we called these reverse queries. We asked the physician to provide the clinical indicators in support of the listed diagnosis or the diagnosis in question. I think you just have to careful to not question the physician's judgment or say the diagnosis is not appropriate based on the clinical indicators. If the physician did not respond or did not provide the clinical indicators, the query was escalated to the physician advisor.

    David Reece, BSN, RN, CCDS
    Manager, Quality Documentation Services
    Premier, Inc.
    Cell: 336-480-7541
    David_Reece@PremierInc.com


    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 8:32 AM
    To: Reece, David
    Subject: [cdi_talk] "anti" query

    I wonder if some may have input to thoughts of an "anti" query...i.e. dx of AKI / acute renal failure. Is it okay to say/ write on the query, that the lab values do not support or meet the criteria for coding acute renal failure? Sometimes I wonder if it is "leading" ? or just stating the facts ?. (especially when the documentation reflects that the creatinine level is related to dehydration) then they are asked for clarification.

    How do others approach an "anti" query with physicians? Especially when it is well documented throughout the medical record.

    The physician has the ability to answer AKI without failure, hemoconcentration of dehydration, azotemia, acute renal failure or other.

    TGIF!! :)


    Lona McNamara RN, BSN, CCM
    CDIS, Cortland Regional Medical Center
    lmcnamara@cortlandregional.org





    ---

    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



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    If you would like to be removed from CDI Talk, please send a blank email to

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  • For our ANTI-queries, we have established within our organization, certain RECOGNIZED criteria for diagnoses-like respiratory failure. We established the criteria with one of our Pulm specialists, and actually have that criteria ON the query. When we query, we ask; "please clarify your supporting clinical indicators from the recognized criteria below", or If using alternate criteria, request they document/ clarify that as well.

    So maybe you could establish criteria from one of you Neph providers and create a policy and query based on that and include that criteria ON your query?

    Good luck!



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 6:32 AM
    To: Bovard, Juli
    Subject: [cdi_talk] "anti" query

    I wonder if some may have input to thoughts of an "anti" query...i.e. dx of AKI / acute renal failure. Is it okay to say/ write on the query, that the lab values do not support or meet the criteria for coding acute renal failure? Sometimes I wonder if it is "leading" ? or just stating the facts ?. (especially when the documentation reflects that the creatinine level is related to dehydration) then they are asked for clarification.

    How do others approach an "anti" query with physicians? Especially when it is well documented throughout the medical record.

    The physician has the ability to answer AKI without failure, hemoconcentration of dehydration, azotemia, acute renal failure or other.

    TGIF!! :)


    Lona McNamara RN, BSN, CCM
    CDIS, Cortland Regional Medical Center
    lmcnamara@cortlandregional.org





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    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



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    If you would like to be removed from CDI Talk, please send a blank email to

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    ----------------------------------------------------------------------
    Regional Health is an integrated health care system with the purpose of helping patients and communities live well.

    Note: The information contained in this message, including any attachments, may be privileged, confidential, or protected from disclosure under state or federal laws . If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please notify the Sender immediately by a "reply to sender only" message and destroy all electronic or paper copies of the communication, including any attachments.
  • Thanks for the "reminder" David. Yes, I initially started with asking for supporting clinical indicators, and I may find it easier to do with other dx , i.e. sepsis...lately, however, especially with AKI/ARF the physicians are just documenting it with reference to the lab value ( and occasionally the value is WNL) and noting the need for hydration. So, I feel inclined to be a little more specific - but, obviously, a little concerned that I am incorrect with how I am preparing my queries. I would never intentionally challenge any of our physicians. They are very receptive to our CDI program! :)

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 8:52 AM
    To: McNamara,Lona A
    Subject: RE:[cdi_talk] "anti" query

    Hi Lona,
    At the last hospital I worked at, we called these reverse queries. We asked the physician to provide the clinical indicators in support of the listed diagnosis or the diagnosis in question. I think you just have to careful to not question the physician's judgment or say the diagnosis is not appropriate based on the clinical indicators. If the physician did not respond or did not provide the clinical indicators, the query was escalated to the physician advisor.

    David Reece, BSN, RN, CCDS
    Manager, Quality Documentation Services
    Premier, Inc.
    Cell: 336-480-7541
    David_Reece@PremierInc.com


    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 8:32 AM
    To: Reece, David
    Subject: [cdi_talk] "anti" query

    I wonder if some may have input to thoughts of an "anti" query...i.e. dx of AKI / acute renal failure. Is it okay to say/ write on the query, that the lab values do not support or meet the criteria for coding acute renal failure? Sometimes I wonder if it is "leading" ? or just stating the facts ?. (especially when the documentation reflects that the creatinine level is related to dehydration) then they are asked for clarification.

    How do others approach an "anti" query with physicians? Especially when it is well documented throughout the medical record.

    The physician has the ability to answer AKI without failure, hemoconcentration of dehydration, azotemia, acute renal failure or other.

    TGIF!! :)


    Lona McNamara RN, BSN, CCM
    CDIS, Cortland Regional Medical Center
    lmcnamara@cortlandregional.org





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    Copyright 2013

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    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



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  • Yes, also recently have asked to meet with our nephrologist and pulmonologist for this! :) we have in the past "agreed" and discussed criteria for respiratory failure, etc. but I believe it is time to re-look at both!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 9:10 AM
    To: McNamara,Lona A
    Subject: RE:[cdi_talk] "anti" query

    For our ANTI-queries, we have established within our organization, certain RECOGNIZED criteria for diagnoses-like respiratory failure. We established the criteria with one of our Pulm specialists, and actually have that criteria ON the query. When we query, we ask; "please clarify your supporting clinical indicators from the recognized criteria below", or If using alternate criteria, request they document/ clarify that as well.

    So maybe you could establish criteria from one of you Neph providers and create a policy and query based on that and include that criteria ON your query?

    Good luck!



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 6:32 AM
    To: Bovard, Juli
    Subject: [cdi_talk] "anti" query

    I wonder if some may have input to thoughts of an "anti" query...i.e. dx of AKI / acute renal failure. Is it okay to say/ write on the query, that the lab values do not support or meet the criteria for coding acute renal failure? Sometimes I wonder if it is "leading" ? or just stating the facts ?. (especially when the documentation reflects that the creatinine level is related to dehydration) then they are asked for clarification.

    How do others approach an "anti" query with physicians? Especially when it is well documented throughout the medical record.

    The physician has the ability to answer AKI without failure, hemoconcentration of dehydration, azotemia, acute renal failure or other.

    TGIF!! :)


    Lona McNamara RN, BSN, CCM
    CDIS, Cortland Regional Medical Center
    lmcnamara@cortlandregional.org





    ---

    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



    You are receiving this message as a member of CDI Talk as: jbovard@regionalhealth.com

    If you would like to be removed from CDI Talk, please send a blank email to

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    Copyright 2013

    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923

    ________________________________
    Regional Health is an integrated health care system with the purpose of helping patients and communities live well.

    Note: The information contained in this message, including any attachments, may be privileged, confidential, or protected from disclosure under state or federal laws . If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please notify the Sender immediately by a "reply to sender only" message and destroy all electronic or paper copies of the communication, including any attachments.



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    Copyright 2013

    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
  • Thank you!

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 8:50 AM
    To: McNamara,Lona A
    Subject: RE:[cdi_talk] "anti" query

    Hi Lona,

    I don't think it's leading. Below is a query I use for an "anti" query.


    Your assistance with confirmation of a documented diagnosis is requested.

    Diagnosis: ___________________is documented in the ________________. It doesn't appear from documentation that patient meets criteria for _______________.

    Would you please confirm and provide any additional relevant information to further support the diagnosis in the patient medical record.

    1. This diagnosis is not confirmed and/or has been ruled out.

    2. This diagnosis is confirmed.

    Please document your clinical rationale_____________________________.



    Paula Scheiderich, RHIT
    Clinical Documentation Specialist
    Oneida Healthcare
    315 363-6000 Ext. 1084
    pscheiderich@oneidahealthcare.org


    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 8:32 AM
    To: Scheiderich, Paula
    Subject: [cdi_talk] "anti" query

    I wonder if some may have input to thoughts of an "anti" query...i.e. dx of AKI / acute renal failure. Is it okay to say/ write on the query, that the lab values do not support or meet the criteria for coding acute renal failure? Sometimes I wonder if it is "leading" ? or just stating the facts ?. (especially when the documentation reflects that the creatinine level is related to dehydration) then they are asked for clarification.

    How do others approach an "anti" query with physicians? Especially when it is well documented throughout the medical record.

    The physician has the ability to answer AKI without failure, hemoconcentration of dehydration, azotemia, acute renal failure or other.

    TGIF!! :)


    Lona McNamara RN, BSN, CCM
    CDIS, Cortland Regional Medical Center
    lmcnamara@cortlandregional.org





    ---

    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



    You are receiving this message as a member of CDI Talk as: pscheiderich@oneidahealthcare.org

    If you would like to be removed from CDI Talk, please send a blank email to

    leave-cdi_talk-20310833.259494049ecb2fb97dab0594bf7e7398@hcprotalk.com

    ---

    Copyright 2013

    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923

    ________________________________
    The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for the use of the person(s) named above. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message.



    ---

    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



    You are receiving this message as a member of CDI Talk as: lmcnamara@cortlandregional.org

    If you would like to be removed from CDI Talk, please send a blank email to

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    Copyright 2013

    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
  • edited March 2016
    I think that referring to what specific criteria you are saying does not appear to be met is essential!

    Thanks for all the great sharing lately and have a Happy V Day!

    Vanessa Falkoff RN
    Clinical Documentation Improvement Coordinator
    University Medical Center of Southern Nevada
    1800 W Charleston Blvd
    Las Vegas, NV
    vanessa.falkoff@umcsn.com
    office 702-383-7322

    Compassion * Accountability * Respect * Integrity



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 6:10 AM
    To: Vanessa Falkoff
    Subject: RE:[cdi_talk] "anti" query

    For our ANTI-queries, we have established within our organization, certain RECOGNIZED criteria for diagnoses-like respiratory failure. We established the criteria with one of our Pulm specialists, and actually have that criteria ON the query. When we query, we ask; "please clarify your supporting clinical indicators from the recognized criteria below", or If using alternate criteria, request they document/ clarify that as well.

    So maybe you could establish criteria from one of you Neph providers and create a policy and query based on that and include that criteria ON your query?

    Good luck!



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, February 12, 2016 6:32 AM
    To: Bovard, Juli
    Subject: [cdi_talk] "anti" query

    I wonder if some may have input to thoughts of an "anti" query...i.e. dx of AKI / acute renal failure. Is it okay to say/ write on the query, that the lab values do not support or meet the criteria for coding acute renal failure? Sometimes I wonder if it is "leading" ? or just stating the facts ?. (especially when the documentation reflects that the creatinine level is related to dehydration) then they are asked for clarification.

    How do others approach an "anti" query with physicians? Especially when it is well documented throughout the medical record.

    The physician has the ability to answer AKI without failure, hemoconcentration of dehydration, azotemia, acute renal failure or other.

    TGIF!! :)


    Lona McNamara RN, BSN, CCM
    CDIS, Cortland Regional Medical Center
    lmcnamara@cortlandregional.org





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