Many CDI specialists struggle with the problem of educating physicians about documentation requirements. Typical trouble areas include acute kidney failure versus acute renal failure or acute renal injury. While some CDI managers have a chance to educate new physician staff in one-on-one...Read More »
Recent CDI-related headlines include concerns about the burden of paperwork on patient care and the cost of healthcare. And article authors cite a few recent surveys to back up such assertions.
Associate Editorial Director Linnea Archibald sends out “missed connections” emails with questions from Council members on a regular basis. Anyone with experience related to one of the questions was invited to respond and Archibald connected them with the question asker. In order to share the...Read More »
Q:Since Acute Renal Failure (ARF) is no longer a MCC (as of October 1, 2010). I would like some input on how facilities have coped with the change. Do you just code ARF, or have you started querying physicians for more specific information such as documentation for...Read More »
Although AHIMA’s October 2008 practice brief “Managing an Effective Query Process” clearly states that the agency intended the article as guidance, not regulation, CDI programs should regularly review their query practices, policies, and procedures to determine if any problem areas may need to...Read More »
Like many CDI specialists, Janice Davis, RN, clinical documentation analyst at High Point (NC) Regional Health System and her four co-workers struggled with obtaining appropriate documentation for chronic kidney disease (CKD) and acute renal failure (ARF). “So we decided if we listed the...Read More »
The concept of standard operating procedures (SOP) might easily call to mind assembly lines or retail-related employee handbooks. But CDI programs should establish such basic operating policies to clarify expectations for CDI staff and the healthcare professionals who interact with them....Read More »
CDI specialists are charged with reviewing concurrent medical records on the hospital floor and clarifying clinical documentation when appropriate. I emphasis the term “appropriate”because there hardly seems to be a time when the opportunity for a clinical query does not exist....Read More »
