Q&A: Productivity measures for CDI specialists

Q: What is the recommended ratio for CDI professionals regarding the number of patients and the number of chart reviews that should be conducted? Also, do you know if any institution is just reviewing Medicare cases or regardless of financial resource?

A: Recommended ratios for chart reviews are difficult to estimate since different CDI programs may have their CDI specialists performing additional tasks such as reviewing for core measures, medical necessity, and the like.

I personally recommend one full time equivalent (FTE) per 1,600 annual discharges. I feel this number provides adequate time to perform a thorough chart review and enough time for multiple follow-up reviews. However, that would be my expectation for an experienced reviewer.  

As for the number of charts per day to expect an individual to be able to review it again depends on the individual’s level of experience. Someone with a year or more or CDI expertise should be able to review a total of 30-35 records per day. This includes about 10 new cases with 20-25 re-reviews (which shouldn’t take much time).  

Most facilities start their programs focusing on a particular payer or service line. Once the impact of the program is validated, programs typically expand their reviews to all payers over time. This is a trend we are seeing nationally. Programs that used to review just Medicare are adding staff so that every patient record is reviewed. In my opinion, this is the best practice. 

Editor’s Note: Lynne Spryszak, RN, CPC-A, CCDS, CDI education director for HCPro, Inc., in Danvers, MA, answered this question. Contact her at lspryszak@hcpro.com.