Note from the Associate Editorial Director: Collaboration key to new query guidance

By Melissa Varnavas

Take a look at the newly released “Guidelines for Achieving a Compliant Query Practice.” Scroll down to end, just before the appendices begin. Note how many people were involved in crafting this seminal document. I counted 21 individuals who worked to prepare it and another dozen or so acknowledgements and that’s just for the 2019 update. There were more than a dozen folks involved on the original, 2013 version, plus more than two dozen listed in the acknowledgements.

Many of these names should be familiar to readers as they represent the brightest thought leaders within the CDI industry including a number of past ACDIS Advisory Board members such as founding members Robert Gold, MD, Gloryanne Bryant, RHIA, CDIP, CCS, and William Haik, MD, FCCP, CDIP, alongside current members Katy Good, RN, BSN, CCDS, CCS, Tamara Hicks, RN, BSN, MHA, CCS, CCDS, ACM-RN, and Susan Schmitz, JD, RN, BSN, CCS, CCDS, CDIP, among others.

My point is simply that the 2019 ACDIS/AHIMA joint physician query practice brief comes as the result of months of meetings filled with discussions about current best practices within the HIM, coding, and CDI worlds and drawing on the plethora of information—from past recommendations from these associations to CMS, Coding Clinic, and Official Guidelines for Coding and Reporting doctrine—which governs compliant query and code assignment work. It represents not only best practice from the perspective of CDI professionals but for anyone engaged in physician query practices.

The continued collaboration of ACDIS and AHIMA mirrors the very collaboration that is essential to effective review and coding processes. We recommend that both CDI and coding teams come together to review the latest brief and engage in a robust dialogue as to how these changes may affect policies and procedures and work across various other departments to ensure that anyone who posits physician queries understands the recommendations within.

New, of note, comes recommendations related to use of information from prior encounters and additional information related to clinical indicators and clinical validity. There’s also a ton of great information related to query forms and formats, definitions and justifications. The ACDIS Advisory Board will review the document in full during its Quarterly Conference Call with the membership on Thursday, February 14, 1 p.m., eastern. We’re looking forward to talking to you.

Editor’s note: Varnavas is the associate editorial director of ACDIS. Contact her at mvarnavas@acdis.org.