The next ACDIS Quarterly Membership Conference Call is scheduled for Wednesday, August 27 (note: not typical Thursday), from 1 to2 p.m. Eastern. Dial-in instructions will be sent to ACDIS members this week (please check your spam filters and email permissions to ensure you receive important information from ACDIS about your membership benefits). If you are an ACDIS member and do not receive your dial-in instructions, contact Member Services Specialist Penny Richards at firstname.lastname@example.org.
These quarterly calls are a means for ACDIS members to network with one another and to discuss any CDI-related issues. We encourage your comments, thoughts, and questions during the call. If you have a question to ask the ACDIS advisory board, or general suggestions for discussion on the upcoming call, please email email@example.com.
Please note that due to heavy call volume, we recommend you dial in 10 minutes early.
The next ACDIS quarterly conference call will be held on Thursday, May 29, 1-2 p.m. ET. Please note that due to heavy call volume, we recommend that you dial in 10 minutes early. Among other subjects, discussion will include the following topics:
- CDI beyond reimbursement: Medical necessity (special guest Glenn Krauss with reference to Novitas Solutions: E/M Service: Face-to-Face Documentation; and the following .ppt: Medical Necessity.
- Implementing electronic queries (special guest Michael McKelvey)
- Querying for hyponatremia in the setting of hyperglycemia
- Including physician “teaching” in queries/functional quadriplegia
- Obesity/BMI as a secondary DX
- Meditech and queries
- Clinical vs. coding guidelines
These calls are offered as a means for ACDIS members to network with one another and to discuss any clinical documentation improvement related issues. We will have a few ACDIS Advisory Board members on the call as well. Conference calls are a great way to ask a question, air any and all CDI concerns, or gather input on a policy or procedure at your hospital. While we cannot guarantee your question or discussion point will be addressed on the call, we will try to work in as many as possible. Note that we cannot answer questions relating to specific code assignment (i.e., which code to assign in a given clinical situation). However, questions about diagnosis sequencing, DRGs, ICD-10 preparedness, etc. are welcomed.
If you are an ACDIS member and did not receive your dial-in instructions please email Penny Richards at firstname.lastname@example.org at least one-hour prior to the start of the program.
The ACDIS Quarterly Membership Conference Call is scheduled for Thursday, Feb. 20, from 1-2 p.m. ET. Dial-in instructions for ACDIS members were sent out this week.
Our next quarterly conference call is scheduled for Thursday, November 21, from 1-2 p.m. ET. To access the call, please dial the toll-free number that was emailed to you.
If you did not receive the email dial-in information please email Penny Richards at email@example.com at least one-day prior to the call.
Due to heavy call volume, please dial in 10 minutes prior to the start of the program. These calls are offered as a means for ACDIS members to network with one another and to discuss any clinical documentation improvement related issues.
We will have a few ACDIS Advisory Board members on the call as well. We encourage your comments, thoughts, and questions during the call. If you would like to submit a topic or question for discussion please email ACDIS Director Brian Murphy at firstname.lastname@example.org
ACDIS members are invited to participate in a Quarterly Conference Call taking place, Thursday, Aug. 22, 1-2 p.m. (EST). Dial-in instructions were sent via email to ACDIS members. If you are an ACDIS member but did not receive your dial-in instructions please email email@example.com for information.
Please note that due to heavy call volume, we recommend that you dial in 10 minutes early.
These calls are offered as a means for ACDIS members to network with one another and to discuss any CDI related issues. We encourage your comments, thoughts, and questions, as ACDIS Advisory Board members will provide feedback during the call. If you would like a particular topic discussed email ACDIS Director Brian Murphy at firstname.lastname@example.org.
Q: I enjoyed listening to the ACDIS quarterly conference call in May. Someone on the call stated they have a physician response rate of 95%. That caused me to wonder what the typical time frame for physician response might be; ours is 48 hours after discharge. I have heard some facilities give two weeks and some give up to 30 days, so I am wondering if there is some standard there
A: Different facilities structure their programs differently. Many have no policy in place regarding expectations related to the timing of the physician’s response. That said, the most successful programs do set expectations typically of about 72 hours, and indicate on the query form, itself, that a response is expected within that time frame.
The goal is to have a high query response rate within that 72 hour time frame. In other words, there is a difference between an organization with a 95% response rate where the queries are closed within 72 hours and one that has a 95% response rate, but the queries are left open indefinitely. Best practice would be to resolve any open query before billing.
Few organizations will hold a claim for 30 days pending a query response, which can result in a re-billing situation if the query response changes the DRG assignment. An effective CDI department can positively impact bill hold times as they work to resolve open queries so the record is complete for coding within days of discharge. Most organizations have a bill hold goal of three to five days. Be sure to address how long a query can remain “open” or awaiting a response within your CDI program policies and procedures.
One of the most important aspects of tracking physician responses is to determine which physicians need extra support and education regarding the importance of CDI efforts. An internal escalation process (such as the samples recently published in the CDI Journal) may be another way to address habitual non-responders. Be sure to get hospital and physician leadership support for your deadlines and share them with the medical staff.
Also, you need to know if your organization voids those queries that no longer impact the DRG. For example, if a CDI specialist leaves a query for a CC but a different CC was coded, that query would be “voided” in some organizations. Then, when calculating your response rates you’d also have to void or remove those queries from the calculation so rather than a non-response counting against the query rate, that particular query would be removed from the equation. Additionally, some organizations “close” a CDI query and “open” a coder query when a patient is discharged if their coding department then follows up on the query so that can impact response rates as well by lowering the CDI response rate.
As you can see, there are a lot of factors to consider when calculating a query response rate so it is difficult to compare organizations without knowing how long queries can remain “open” awaiting a response and what query resolution processes are in place. Remember the value of the CDI department is in issuing queries to clarify incomplete, vague or missing documentation so query resolution should be a prominent task within the CDI role.