CDIS Accuracy Rates by Audits

rdbrayrdbray
in CDI Management

I've been tasked to create some type of CDIS accuracy rate on reviews. Does anyone do audits on CDIS? If so,

1) What criteria do you utilize to determine accuracy?

a) Missed opportunity for query

b) How many records do you review for each staff member?

c) How frequently do you perform audits?

d) What items are being audited?

2) Which staff members perform the audits?

3) When do you perform audits, concurrently or retrospectively?

4) Do you have a standard metric percentage for accuracy rate? i.e., 70%, 80%, 90% with what goal?

5) Please feel free to provide any additional information.

Thanks,

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Comments

  • SwartK@upstate.eduSwartK@upstate.edu

    1) program objectives - DRG assignment, PDX accuracy (sequencing and specificity), essential modifiers, essential PCS codes (approach and root operation), quality

    a) Missed opportunity for query - yes, this as well as missed risk adjustment identification and escalation of quality issues

    b) Not standardized at the moment - based on records that come back as incorrect

    c) Not standardized - more ongoing based on accounts that come back as incorrect

    d) What items are being audited? Above.

    2) Currently me - Second Level Review team will take over

    3) currently retrospective, goal is concurrent and retrospective

    4) based on proficiency and tenure in department/role - 80% within first year and progressive

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