Journal excerpt: CDI and coding don’t get along. Now what?

By Trey La Charité, MD, FACP, SFHM, CCS, CCDS

I cannot emphasize enough the need for CDI and coding to reside under the same organizational umbrella. In my opinion, CDI and coding should not be housed in separate or independent operational areas of the hospital. If they are, it could lead to silos of information.

Many programs have the coders in one area of hospital operations (usually medical records) and the CDI personnel in another (revenue integrity, quality management, performance improvement, etc.). This may work in some facilities, provided the programs establish clear methods of communication, but …to me, the chance of missed communication leading to the development of competing priorities and opposing directives—seems way too high.

My hospital has always grouped CDI and coding within our medical records department. It was assumed from the beginning that the two programs would need to work together closely, so it was an easy decision to structure them in the same department from the very start. If both entities have to live and play in the same sandbox, they will ultimately have no choice but to develop a working agreement such that both will survive and succeed.

However, beyond the unified organizational structure, the two programs at UTMC also physically reside in the same work space. This promotes personal interaction, resulting in the free exchange of ideas. How easy is it to ask people for their help, expertise, or advice when they sit next to you as opposed on the other side of campus?

Editor’s note: This article is an excerpt from Dr. La Charité’s “Physician Advisor’s” column in the November/December edition of CDI Journal. ACDIS members can read the entire issue, here.