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Update: Local Chapter meetings

There are few upcoming meetings I wanted to bring to your attention.

First, the FL ACDIS Chapter meets tomorrow, Saturday, March 17, 9:30 a.m. to 3:30 p.m. at Regional Medical Center, Bayonet Point, in Hudson. The agenda includes:

• Pastries and coffee, donated by Panera Bread, and registration/opening comments
• George Klimis discussion of “The Road to Outpatient CDI”
• Dr. Mark Michelman Q&A: “Ask a Physician: Clinical Questions from the Florida Chapter ACDIS Membership”
• Lunch, featuring homemade corned beef and cabbage and sandwiches from Publix (mint chocolate brownies and Irish crème cake for dessert)
• Sylvia Hoffman presentation titled “Keeping the Wolf at Bay: Query Compliance and Risk Reduction.”

There will be five raffle baskets themed:

• Quality Time with Your Pet
• Sweet Treats
• Time to Garden Gift
• Relaxing Over Spring Break
• Leprechaun’s Delight

One lucky raffle winner will earn money towards their ACDIS Conference attendance expenses.

The meeting’s game will be in a Family Feud format with limericks regarding predetermined diagnoses likely to represent those patients. The teams will try to guess the diagnoses and receive a shamrock coin for each correct guess. The team with the most shamrocks wins St. Patrick’s Day-themed prizes.

For more information about the Florida ACDIS Chapter, visit its website http://flacdis.org/.

Next, I wanted to share the following thoughts written by Judi Bates, RN, BSN, CCDS, CDI specialist at Our Lady of Lourdes Medical Center in Camden, NJ, who has teamed up with Debby Dallen, RN, clinical documentation coordinator at Albert Einstein Medical Center in Philadelphia, to host the first Philadelphia regional CDI networking meeting. Excited about the event which which will be held Thursday, March 22, 8-10:30 a.m., at Our Lady of Lourdes Medical Center, Bates writes:

“Nothing grows in a vacuum. With that thought in mind a new networking group will have their first meeting on Thursday, March 22. The ACDIS website is a great way to collaborate via e-mail/CDI Talk and the ACDIS Blog. For some, that little bit of networking is all they need. But I am excited about being able to go to an ACDIS local chapter meeting, where we can share and learn in a face-to-face venue. Whether our gathering proves to be big or small, I know this forum will be a catalyst to solving problems and working efficiently.

“The purpose of an organized meeting in the local area is to share; share the good, bad, and ugly of our profession. Actually I hope that when we do gather next week, our discussions will mostly be about the positive aspects of our jobs and that when we do discuss problem areas that  we may help one another through our CDI growing pains. I am looking forward to talking with like-minded people, people who won’t give me that quizzical look when I tell them my title is CDI specialist.

“When I started as a CDI specialist more than three years ago, it didn’t take long before I was curious to see how other people did this job. I also wanted to pick people’s brains about what didn’t work and what did at their facilities. Efficiency is the name of the game, after all. That was when I began chatting with many individuals via ACDIS, one of which is the co-chair of this group, Deb Dallen.

“Our paths have crossed a few times over the years but it wasn’t until ACDIS Associate Director Melissa Varnavas suggested we start this group that we got together. So we are hoping to have lots of CDI specialists join us next week. We hope you’ll come with great ideas and positive energy to spark the potential for improvements in world of CDI in this area.

“Membership to ACDIS is not mandatory, so if you know someone who doesn’t belong and is interested, bring them along. You can find all the information you need under the tab ‘Local Chapters’.”

Bates and Dallen say that the first meeting will be informal and informational in nature featuring a meet-and-greet and open networking discussion. RSPV to Judi Bates via e-mail at Batesj@lourdesnet.org, or by phone at 856/757-3161. Or contact, Debby Dallen at dallend@einstein.edu, or by phone at 215/456-8902.

As a reminder, the North Carolina, South Carolina, and Minnesota ACDIS Chapters all also meet in the coming weeks. Like Judi, we know how valuable these local networking events can be. Frequently, they present an inexpensive way to stay informed on important CDI-related topics, and to learn from others’ experiences.

You can find a list of meeting information in a previous ACDIS Blog post or by visiting the Chapter Meeting tab under the Local Meetings section of the ACDIS website.

Send in your CDI success stories!

Greetings ACDIS members, I hope you’re all having a great Clinical Documentation Improvement Week. I know I am!

If you’ve been following our suggested week’s activities , you’ll know that today is the start of a fun (and we hope inspiring) contest.

We’re asking to hear from you about your best CDI success story. This can mean many things: For example, a successful process you developed, a difficult query you had answered, a department goal you met, or a tough physician you won over.  It might be about when you had your first “got it” moment as a new CDI specialist, and realized you could do this challenging job after all.

We will publish some of these success stories on the ACDIS website and in the next CDI Journal.  As a bonus, the 10th and 50th respondents will win an ACDIS book or audio conference of their choice.

These stories can be as short as a paragraph or as detailed as you’d like. You can send them to me directly at bmurphy@cdiassociation.com.

The cutoff date for your stories is week’s end. I’ve received a few great stories so far; keep them coming!

Take care,

Brian

September meetings include CDI Week after-hours events

Connecticut

The CT CDI networking group meets Thursday, September 8, 9-10:30  a.m., at The Hospital of Central Connecticut, Bradley Memorial Campus in Southington. For information, contact MaryAnn Shanley at mshanley24@yahoo.com.

Georgia

The next Southeast ACDIS meeting will take place Friday, September 9, 10 a.m. to 2 p.m., at the Medical Center of Central Georgia in Macon. RSVPs are requested to Jamie Doster at james.doster@emoryhealthcare.org or by phone at 404/578-0262.

Plan to arrive by 9:20 a.m. to allow time for parking, registration, morning refreshments, and networking. Save time by submitting your membership application (see below) and pay dues to the treasurer prior to the meeting date. Attached are:

• Membership application if you wish to join the chapter. Annual dues are $25 with check made payable to “SECACDIS.” All quarterly meetings are included in the membership dues.
• Meeting attendance application: Application to attend just one meeting for non-chapter members. Cost is $10 per meeting.
• Agenda: Note the meeting will be from 10 a.m. to 2 p.m. There will be an optional Facebook crash course following the meeting for those wishing to learn how to interact on the chapter’s Facebook site.
• Minutes from the last meeting in June to be voted on.
• Bylaws to be voted on at next meeting.

New York

A CDI round table discussion will be held on Thursday, September 15, 11 a.m. to 3 p.m. at Mount Sinai Medical Center in New York City. For information, contact Than Than Lee at 212/824-8180 or email ThanThan.Lee@mountsinai.org.

CDI Week Meetings

(Editor’s Note: Meeting locations listed in italic denote special, after-hours events associated with CDI Week not necessarily formal “chapter” events.)

San Francisco Bay, CA

Is organizing a happy hour meet-and-greet for CDI and related professionals on Wednesday, September 21, 5-8 p.m. at the Clement Street Bar and Grill. All CDI-related professionals are welcome to drop by for drinks and/or appetizers and dinner. RSVP to dexter.g.dcosta@kp.org or call 573/529-1791.

N. Illinois

The next Northern Illinois CDI chapter meeting will be at Delnor in Geneva, on Thursday, September 22, 1-3:30 p.m. For information, contact Colleen M. Stukenberg by phone at 815/599-6820 or by e-mail at CStukenberg@fhn.org.

Las Vegas, NV

The Nevada ACDIS Chapter will host a CDI Week happy hour Friday, September 23, 5-8 p.m., at the Fire Fly, 3900 Paradise

Take a peek at the Fire Fly menu. Those Vegas CDI professionals sure know how to celebrate CDI Week. Want to host an after-hours event for CDI in your area? Post the information below or email mvarnavas@ cdiassociation.com

Road, Las Vegas. The event is a “buy your own” but because it is a tapas bar, items are typically under $10. It should be a bunch of fun and a great networking opportunity! Here is a link to their website if you want to see what they have.

RSVP to Alisa Kompare at Ailsa.Kompare@kindredhealthcare.com or call 702/343-7232.

Los Angeles, CA

A gathering of  CDI-colleagues from the Los Angeles and San Gabriel Valley areas are invited to attend a happy hour event in honor of CDI Week Friday, September, 23, 5-8 p.m., at the Yard House – Paseo Colorado in Pasadena. For information and to RSVP contact, Cris Gumayagay at cris.gumayagay@ahmchealth.com.

California

Our next ACDIS-CA Chapter meeting is scheduled for Wednesday, September 28, 9-10 a.m. The speaker will be Wendy DeVreugd from Kindred Healthcare who will be presenting on Kindred’s model of CDI. For information, contact Dexter D’Costa at dexter.g.dcosta@kp.org or by phone at 573/529-1791.

Save-the-date

New England

The NE Regional CDI  network meets Wednesday, October 5, 1-3:30 p.m., at Lowell General Hospital’s Clark Auditorium. The meeting will feature a presentation by Richard Birkhead, MD, FACC, Chief of Cardiology regarding documentation for fluid overload vs CHF, Cor Pulmonale, pericarditis, and tamonade, among other topics. For information, contact Kelley Sears at Kelley.Sears@steward.org or call 508/954-7432.

Tri-State (WI, MI, MN)

The ACDIS Chapter leaders from Wisconsin, Michigan, and Minnesota invite CDI specialists and related professionals to join them for the first Tri-State Regional Meeting Saturday, October 15, 9 a.m. to 5 p.m., at Kalahari Resorts in Wisconsin Dells, WI. The agenda includes:

• Registration
• Strategies for dealing with difficult physicians
• Physician query process: The ins and outs
• Lunch
• Continually educating physicians to avoid staleness in your program
• Over documentation: Challenges and Solutions
• Collaboration between coders and CDI professionals to break down the silos
• Roundtable discussion

Continental breakfast and lunch will be provided. Five CEs will be provided for those who need CEs for the CCDS credentials. For those needing lodging a block of rooms has been reserved for October 14 and 15 at $129 per night inclusive of taxes. Reservations can be made by calling the Kalahari directly at 877/253-5466 by Wednesday, September 14 and request the WI-ACDIS room block. After this date, the prevailing hotel room rate may be charged at the discretion of the hotel.

Registration is $50 and the deadline is October 1. For information, contact Heidi Hillstrom at HHillstrom@slhduluth.com or call 218/249-5461.

Virginia

The fifth quarterly ACDIS Virginia Chapter will meet Saturday, October 22, with Robert Gold, MD, CEO of DCBA, Inc.,  as the guest speaker. Gold will discuss “CDI Initiatives: Start now for ICD-10.” For information, contact Linda Steinhoff by phone at 757/312-5154 or email Linda.Steinhoff@chesapeakeregional.com.

May meetings for local chapters

Joining a local CDI networking group is one way to get off the routine CDI treadmill and find innovative ways to enhance your team's performance.

Connecticut

During the next Connecticut ACDIS Chapter meeting on Thursday, May 12, memebers will discuss the creation of chapter bylaws and mission statement, complete a learning module regarding principal diagnosis and share tools for the creation of a chapter resource library. For information, contact MaryAnn Shanley at mshanley24@yahoo.com. Read the minutes from the March meeting.

Illinois

St. Alexius Medical Center hosts the next N. Illinois ACDIS Chapter meeting on Friday, May 13, from 12:30-3 p.m. Possible agenda items include sharing information learned from the 4^th Annual ACDIS conference and recent RAC findings/experiences. For information, contact Ellen Chang, RN, CCDS, Clinical Documentation Manager, at 847/755-7610 or by e-mail at Ellen.chang@alexian.net.

Maine

The next Maine ACDIS Meeting will be held Tuesday, May 17, 1-5 p.m., at Eastern Maine Medical Center in Brewer. Agenda includes:

• Updates from 2011 ACDIS National Conference
• CEUs for local meetings
• Networking
• ACDIS website demonstration
• Group structure

Hawaii

The Hawaii ACDIS Chapter meets Wednesday, May 18, from noon to 1:30 p.m., at Castle Medical Center where attendees will listen to and discuss the HCPro audio conference “Short Stays: A Data Driven Approach to Medical Necessity.” For information, contact Eleu Zane at Eleu.Zane@palimomi.org.

Ohio

The Columbus, OH, ACDIS Chapter meets Thursday, May 19th. For information, contact Sheri Blanchard, RN, Clinical Documentation Specialist, at Arthur G. James Cancer Hospital at 614/366-4197.

Florida

The next meeting of the Florida ACDIS Chapter themed “Another Day in Paradise,” takes place Friday, May 20, 9 a.m. to 2 p.m., at Jupiter Medical Center in Jupiter, FL. The agenda includes:

• Registration and breakfast
• Margi Brown, consultant: “Blending Denials into the CDI Mix”
• Raffles and networking
• Cortnie Simmons and Cheryl Bowling, Kforce Healthcare: “Translating ICD-9 to ICD 10 for Common Diagnosis
• Lunch and networking
• Cathy Cover, manager of RAC Denials at MPM and Dr. Mark Michelman, physician advisor at MPM: “Sink or Swim: Surviving the RAC Attack

Reserversations requested. Contact Iris at 561/745-5783. First time attendees are welcome. CEUs cost $10.

Be sure to visit FL ACDIS’ Facebook page http://www.facebook.com/acdisflorida and its new website http://flacdis.org/.

Click on this link to read the latest FL ACDIS Newsletter.

Wisconsin

The First Annual WI ACDIS Conference will be held on Saturday, May 21, 10 a.m. to 3 p.m., at Wheaton Franciscan Healthcare, in Wauwatosa. The meeting titled “Clinical Informatics for the CDIS Query Process,” includes:

• “Recognition of Atypical Clinical Presentations and the Query Process” by Dr. Gamal Eskander
• “Highlights of the 4th Annual ACDIS Conference including legal perils of physician querying” by Lynn Sisler, Diane Draize, and Glenn Krauss.
• “Sharing of CDIS Best Practices from WI ACDIS Members,” a panel discussion.
• “Recognition of Query Opportunities,” role playing participations of verbal and written query dissemination.
• “The Expanded Role of CDI specialists,” discussion of how to collaborate with case management.

CCDS CEUs offered. Buffet Lunch will be provided and ample time will be available for chapter networking. RSVP required. Registration will be from 9-9:45 a.m. Meeting will start promptly at 10 a.m. Registration fee is $20 and includes lunch, drinks, and morning coffee.

For information, contact Diane Draize at Diane.Draize@ministryhealth.org or by phone at 920/743-5566 ext. 3143; Joan Korn at Joan.Korn@wfhc.org or by phone at 414/647-5248; Glenn Krauss at GlennKrauss@earthlink.net or by phone at 603/303-3337.

California
The next California meeting takes place Wednesday, May 25, 9-10 a.m., via webinar. For information, contact Dexter D’Costa, dr_dexterdcosta@yahoo.com.

Minnesota

The next Minnesota ACDIS Chapter teleconference meeting will be held Wednesday, May 25, at 1 p.m., hosted by North Memorial Health Care in Robbinsdale, MN. For information, contact Nancy Barnes at Nancy.Barnes@NorthMemorial.com or call 763/520-1974. Or contact MN Chapter leader Heidi Hillstrom by e-mail at hhillstrom@slhduluth.com.

2011 ACDIS conference poster session submissions closed

Hi everyone, due to a large number of submissions and limited space, we are no longer accepting applications for the 2011 ACDIS 4th annual conference poster session.

I think you’ll love our lineup of posters and I hope to see you in Orlando!

Thanks,

Brian

OIG report says CMS should use its own data to target trouble documentation

As CDI specialists, we find ourselves trying to keep the attention of our physician audience. The ability to positively engage the physician depends on continually illuminating the direct correlation between accurate and complete clinical documentation and the ongoing evolution of the business of the practice of medicine.

I call your attention to an October report from the Office of the Inspector General (OIG), Center for Medicare and

All eyes are on physician documentation. Let the doctor's know, too.

Medicaid Services’ Use of Medicare Fee-For-Service Error Rate Data to Identify And Focus On Error-Prone Providers, which essentially found that CMS did not use data from its historical Hospital Payment Monitoring Program (HPMP) and Comprehensive Error Rate Testing (CERT) Program  to identify and focus on providers with the highest rates of mistakes.

HPMP, now part of the CERT program, is charged to measure, monitor, and reduce the incidence of improper fee-for-service inpatient acute care Medicare payments by conducting reviews of inpatient admissions to validate accuracy of code and MS-DRG assignment in addition to issuing determinations of medical necessity. The CERT contractor has assumed responsibilities for inpatient record review for calculating the national fee-for-service Medicare payment error rate.

CMS established the CERT program to calculate a national claims error rate for the entire Medicare Fee-For-Service program. The CERT program calculates the error rates for all Medicare Administrative Contractors (MACs) and, until the transition to MACs is completed, the CERT program will also report on carriers, and fiscal intermediaries (FIs). The CERT:

• Randomly selects a sample of approximately 100,000 claims submitted to carriers, FIs, and MACs during each reporting period
• Requests medical records from the healthcare providers that submitted the claims in the sample
• Reviews the claims in the sample and the associated medical records to see if the claims complied with Medicare coverage, coding, and billing rules, and, if not, assigns errors to the claims
• Classifies cases as a ‘no documentation claim’ counting it as an error where medical records are not submitted by the provider
• Sends providers overpayment letters/notices or makes adjustments for claims that were overpaid or underpaid

The CERT program began in 1996. It reports a national paid claims error rate which is based on dollars paid after the Medicare contractor made its payment decision on the claim. This rate includes fully denied claims. The paid claims error rate is the percentage of total dollars that all Medicare FFS contractors erroneously paid or denied. It is a good indicator of how claim errors in the Medicare FFS Program affect the Medicare trust fund. For fiscal year 2009, the national paid claims error rate was 7.8% equating to $24.1 billion.

The CERT program cannot be considered a measure of the cost of healthcare fraud, however. Since the CERT Program uses random samples to select claims, reviewers are often unable to see provider billing patterns that indicate potential fraud when making payment determinations. The CERT program does not, and cannot, label a claim fraudulent.

This last point of identifying individual physician practice patterns of improper physician claims submission was at the gist of the objectives of this OIG review.

The OIG wanted to find out to what extent CMS and its contractors used HPMP and CERT data between fiscal year 2005 and 2008 to identify error-prone providers and initiate corrective actions to address patterns of improper coding and claims submissions.

This OIG examined CERT and HPMP results between 2205-2008 and identified 740 error-prone providers—providers that had at least one claims error in each of the four years of the audit period. Its analysis of the HPMP error rate data showed 554 providers (21% of all HPMP providers with at least one claim sampled in each of the four years) accounted for 59% of the dollars in error for those providers. A similar analysis of the CERT error rate data for the same period disclosed that 186 providers (1.81% of all CERT providers with at least one claim sampled in each of the four years) accounted for 25% of the dollars in error for those providers. [more]

Ode to my Mom

Sylvia offers her mom an ode for Mother's Day.

My mother cuts out coupons, news articles and such,
She calls me at all hours (sometimes I think it’s too much)

My mother loves me dearly; she hugs a bit too tight
She always gives me kind advice; sometimes she’s even right

My mother goes to bingo, and rarely does she cook or bake
She drives a great big Cadillac, she claims for safety sake

My mothers’ dogs’ named Rocky; she loves him like a son
She brags about her children, including the four legged one

My mother likes bright shiny things; they seem to catch her eye
She loves to open presents, with gifts she’s never shy

Her favorite day is Mother’s Day; her kids all come and hover
To sing her praise with glasses raised, to honor our sweet mother

I am like her, I’m proud to say,
I’ll love my mother all my days!

Happy Mother’s Day!

Local meeting reminders: Dates for the end of April

Missouri

The Kansas City CDI meeting is slated for tomorrow, Wednesday, April 21,  3–4:30 p.m., at the Shawnee Mission Medical Center. On the agenda are:

• Introduction of new members
• Identify volunteer to take minutes
• Education Sharing
• New topics for discussion
  • Share feedback from trainers – Shawnee Mission staff
  • Share malnutrition assessment form developed at Carondelet Health- f/u from last meeting-Kathleen Daniels
  • Discuss how other hospitals are set up-how do they prioritize work, how much on floor-Ellen Ellis Heartland
  • What are your most common query opportunities?-Joann
• Determine location for next meeting-July 2010
• Meeting Evaluation

For information, contact Joann A. Agin, RHIT, regional manager, data quality at Carondelet Health in Kansas City, MO, at 816/943-2115 or e-mail jagin@carondelet.com.

Nevada

Hosts its first face-to-face meeting during a “no-host” luncheon April 23, 11:30 a.m. to 1:30 p.m., at the coffee shop at Siena Hotel Spa & Casino, Reno, NV. For information, contact Laura Werner at LWerner@cvmchospital.org or by phone at 775/783-3064.

Minnesota

The next Minnesota CDI meeting will be held Wednesday, April 28, 1-2:30 p.m., at the Methodist Hospital. For information, contact Mark LeBlanc at 952/993-5692 mark.leblanc@parknicollet.com.

New England

The Northeast Regional CDS Meeting will be held at South Shore Hospital, Thursday, April 29, 1-3 p.m. For information contact, Bernadine_Darienzzo@sshosp.org or call 781/624-4289 or Elizabeth_Trout@sshosp.org 781/624-8415.

Long Island, NY

The next NY/LI Local Chapter meeting will be hosted by Stony Brook University Medical Center on Monday, April 26, 3-5 p.m. For information, contact Adelaide La Rosa, RN,  at 516/562–6278 or by e-mail at Adelaide.Larosa@chsli.org.

Georgia

Elections for the Southeastern Chapter of ACDIS officers are now open. Please access the electronic ballot to cast your votes. The Web site will close to voting on April 30, at noon. All instructions are posted on the site.  The induction of officers will take place on May 7. For information, contact Maria Mann RN, BSN, Clinical Documentation Specialist at Gwinnett Medical Center- Duluth, GA, at 678/312-6963 or by e-mail at mmann@gwinnettmedicalcenter.org.

Hyatt rates lowered to $184, rooms sold out Friday and Saturday

We have some great news regarding room availability and rates. Conference rooms are very tight due to a huge citywide American Society of Clinical Oncology association meeting going on at the same time as ACDIS. After much wheeling, dealing, and negotiation, we have freed up a room block at the Hyatt Regency a lower rate than previously: Rooms can now be had for just $184/night. The Hyatt will honor this room rate for all rooms already booked under the ACDIS room block.

We currently have less than 200 rooms available at the Hyatt in our ACDIS room block for the nights of June 2 and 3, so please book your rooms as soon as possible. When you book please indicate that you are with ACDIS and mention HCPro. Unfortunately, the Hyatt is already sold out for the Friday and Saturday evening following the conference.

Physician CDI training available online

Does this ever happen to you? Seems like once I get on my soap box about an issue here on the ACDIS Blog that same issue consistently peeks out in a variety of other venues.

Last week I shared what I assumed would be your dismay at a physician blogger’s desciption of clinical documentation as a waste of time and potentially a hazard to patient care. I frequently hear ACDIS members bemoan the difficulty of physician buy-in. What can we do about it?

And then I received an e-mail from Ruthann Russo, PhD, from Clinical Documentation Matters, offering a series of free Webinars regarding… you guessed it…  Physician Support for CDI:  Using the theory of high quality clinical documentation to pull your medical staff into documentation compliance.

Her Web-cast is free, you just have to register.