ACDIS tip: Concurrent coding offers an opportunity for real-time reporting

Much like concurrent CDI reviews, the concurrent coding process requires coders to follow the chart throughout the patient’s admission and code it at intervals. The hope is that this process limits the number of clarifications needed after discharge, allowing the organization to send the final bill sooner. According to a recent ACDIS survey, 47.51% of the 603 respondents currently have a concurrent coding program.

Since coded data is used for so many things now, the accuracy of that data has never been more important. The practice of concurrent coding ensures the data is accurate, in real-time, with the patient’s stay.

Plus, as the chart is coded concurrently, the CDI specialists are able to immediately see where coding difficulties may arise, says Diana Ortiz, JD, RN, CCDS, CDI product owner at 3M Health Information Systems in Murray, Utah.

“I don’t want to say things were more accurate [with a concurrent coding process in place], but things were accurate quicker,” Ortiz says of implementing a concurrent coding program at her previous facility. “It also helps with the back-end reconciliation process.”

And knowing how the chart will code out concurrently doesn’t only help CDI, Ortiz adds. According to the ACDIS survey, 53.05% of respondents say the goal of their concurrent coding program is to improve coding of potential quality indicators during the patient’s stay.

“A lot of the time, the quality team is looking at the [more] basic coding that CDI specialists are [traditionally] doing concurrently. Because coders are more in tune with coding guidelines than CDI specialists, there may be differences in final coding versus working codes,” she says. “Following those quality measures more concurrently from a better [clinical and coding] truth perspective is a good thing.”

In fact, the accuracy of quality measures may be the exact thing a new concurrent program focuses on. That’s the case for CentraState Medical Center in Freehold, New Jersey, which only performs concurrent coding on charts suspected to include a hospital-acquired condition (HAC) or a Patient Safety Indicator (PSI), says Christine Butka, RN, MSN, CCDS, CDI manager at CentraState.

“It helps us get the patients out of the PSI or HAC, if we can, during the stay or it helps us understand if we’ve triggered it so we don’t have to do that work of figuring it out on the back end,” says Butka.

Though the mechanics of the concurrent coding process can pose CDI and coding challenges, some programs will find that the benefits for quality and accurate coding far outweigh the drawbacks.

Editor’s note: This article is an excerpt from an article in the November/December CDI Journal. To read more about the concurrent coding process, click here.