Tip: Interdepartmental respect improves communication

It took some time to break down the wall between coders and CDI specialists at New Hanover Regional Medical Center in Wilmington, N.C. However, that wall eventually crumbled. Linda Rhodes, RN, BSN, CCDS, manager of CDI, says an increased emphasis on communication and respect is what did the trick. In particular, the 769-bed facility implemented a coder/CDI roundtable that became the cornerstone of its success, she says.

"The goal is to learn from each other's perspectives," says Rhodes. "We each have something important to offer."

During roundtable discussions, participants perform post-bill case reviews of specific cases chosen in advance by a coding auditor and a CDI educator. Cases tend to focus on those for which principal diagnosis assignment is unclear. The coexisting principal diagnosis guideline often generates interesting discussions, says Rhodes.

For example, coders often justify their decision to report pneumonia as a principal diagnosis when a patient also has congestive heart failure because the pneumonia yields a higher-weighted DRG. CDI specialists can help coders identify when the congestive heart failure is the focus of the treatment, thereby justifying it-rather than the pneumonia-as the principal diagnosis.

Editor’s Note: This article is an excerpt from Briefings on Coding Compliance Strategies August issue.