Routine Labs used as "treatment" for querying?

Coonan6@gmail.comCoonan6@gmail.com
in Clinical & Coding
I was taught that daily routine labs should not be used as a "treatment" when querying. I am currently working with a CDI department that supports the use of daily lab values as the only treatment listed in some of their queries.  This is especially true if they are querying for the clinical significance of an abnormal lab.  Where would be the best place to educate myself on what can be considered treatment on a query form?  I do have 2 years of CDI experience.
Theresa Coonan BSN, RN

Comments

  • lprescott1lprescott1
    Theresa, this a great question and one that we often discuss in our bootcamps. We teach that one abnormal lab likely is not enough for a query. Look for trends, does the provider speak to the significance, for example a statement that reflects on a need for continued monitoring? for example of the provider makes comment related to a declining H&H in progress notes and also reorders the lab for the next day I would see this as likely significant enough to query. Or if daily labs demonstrate an increasing creatinine and the provider is ordering increased fluids or makes comment related to patient's level of hydration, a query is likely applicable. This is an area where the CDI must apply critical thinking related to the specific lab value and the provider's response. Each situation is unique in what is the proper response. 
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