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Conference Update: It’s the final countdown; speaker Q&A

Kelli Estes

Kelli Estes, RN, CCDS

It’s official—the 2015 ACDIS conference is less than two weeks away. That means there is less than a week left to register. Don’t wait until the last minute!

The conference takes place May 19-21, 2015, in San Antonio, Texas at the Henry B. Gonzalez Convention Center, and features four tracks that include a diverse range of sessions on the latest trends and cutting-edge techniques to enhance CDI programs. The tracks are:

  • Management and leadership
  • Clinical and coding
  • Quality and regulatory initiatives
  • Innovative CDI

To view the full agenda and details, download the conference brochure.

As you put the final touches on your itinerary, we’re continuing to preview some of speakers to give you a feel for this year’s sessions. This week, we spoke with Kelli A. Estes, RN, CCDS, who, along with Cesar M. Limjoco, MD, will present, “Go After the Truth, the Clinical Truth—That’s What Matters at the End of the Day.”

Q: Why is it important for CDI specialists and coders to capture conditions based on clinical truth?

A: At the end of the day, the clinical truth—the documented evidence within the medical record regarding the patient’s conditions—will be what helps the facility stand up in the face of auditor scrutiny. Although metrics and productivity are very important, CDI specialists must use caution when allowing those things to dictate the overall quality of their performance when querying providers. For example, if two out of the four Systemic Inflammatory Response Syndrome (SIRS) criteria are satisfied, we all too often see CDI specialists’ query for sepsis, even though it may not be clinically supported. The SIRS criteria are to be considered a screening tool, not a diagnostic tool.

Q: How is your topic important for everyone in the CDI role, regardless of professional background?

A: Doing the right thing for the right reason will always yield results which benefits everyone involved. Additionally, publicly-reported data will more truthfully reflect of how sick patients are in any given organization, while the appropriate financials will match resource utilization more accurately.

Q: How did you become interested in CDI?

A: I began working in CDI in 2000 for a regional hospital in Kentucky. At the time, I didn’t fully understand what I was getting into. But, as I began to grow in my knowledge base and build relationships with the coding department, I quickly recognized this unique opportunity to make a real difference in the outcomes of patient data. I began to understand enough about coding to assist providers with improving their documentation, to more accurately reflect how sick their patients actually are while still in the acute care setting. It was easy to see the different perspectives between the providers and the coders, but they needed someone, a CDI specialist, to help close the gap.

Q: What do you think is the most important quality for a CDI professional to have?

A: Relationship building with providers is one of the most important assets any CDI specialist can bring to the table. However, critical thinking skills in the clinical arena are extremely important as well.

Q: Why do you think attending the ACDIS conference is important?

A: I’ve personally attended every ACDIS conference since the beginning. The value in networking with others in your field is always valuable, as well as having the opportunity to choose from a variety of breakout sessions to glean helpful information applicable to the constant flow of changes healthcare faces. In addition, it is a great way to meet the requirements for the CCDS certification renewal.

Conference Update: Registration ending soon; Speaker Q&A

The 2015 ACDIS conference takes place in San Antonio, Texas

The 2015 ACDIS conference takes place in San Antonio, Texas

The annual conference is just three weeks away! And there’s only two weeks left to register.

The conference takes place May 19-21, 2015, in San Antonio, Texas at the Henry B. Gonzalez Convention Center, and features four tracks that include a diverse range of sessions on the latest trends and cutting-edge techniques to enhance CDI programs. The tracks are:

  1. Management and leadership
  2. Clinical and coding
  3. Quality and regulatory initiatives
  4. Innovative CDI

To view the full agenda and details, download the conference brochure.

As we head in to the final few weeks before the conference begins, we’re continuing to preview some of our speakers, to help you get a feel for the sessions we’ll be offering and put the final touches on your itinerary. This week, we spoke with Karen Chase, RNC, BSN, CCDS, assistant CDI director at Stony Brook Medicine, who will present “Revitalizing a CDI Program for Physician Engagement.”

Q: Why is physician engagement so critical for CDI programs?

A: Physician engagement is important on so many different levels. Whether you’re a new CDI program, or an established one, my session will cover a variety of techniques. I’ll go over how to build a platform to help achieve buy-in from administration, as well as how to engage the physicians in your program. I’ll also be looking at how to monitor and showcase a program’s progress, and keep administration aware of its achievements. This lecture can also help established programs that might feel stagnant in their current mission and vision. I’ll be talking about the need to go beyond traditional CC/MCC capture, and engage physicians to improve both revenue and quality metrics.

Q: How is your topic important for everyone in the CDI role, regardless of professional background?

A: This session applies to just about everyone. I will address some of the key issues that can lead to a successful implementation of new CDI program, or revitalize an old program.

Q: As an RN, how does your perspective differ from other professionals performing the CDI role?

A: As a nurse, I have clinical expertise to support the analysis of the medical record. This allows me to draw from my nursing background to help predict the diagnoses being treated, so I can help the medical team to support them in the chart. I also have a strong quality and data background, which allows me to have a good grasp on how administrative data affects the perceived quality outcomes, and what can be done to change it.

Q: What do you think is the most important quality for a CDI professional to have?

A: The ability to work independently. They should be detail-oriented, while understanding the big picture. Most importantly, they should be comfortable with change and be able to adapt to any situation.

Q: Why do you think attending the ACDIS conference is important?

A: I think that attending the ACDIS conference is very important. Along with networking, it gives CDI specialists a chance to establish best practices for the profession. I am looking forward to networking with professionals all over the nation, and incorporating some of their ideas and practices in to mine.

Conference Update: Speaker Q&A

There is so much to learn from the annual ACDIS National Conference.

The annual ACDIS Conference is in 27 days.

We’re less than a month away from the annual conference! And to help you narrow down your final itinerary, we’re previewing a handful of speakers to help you get a feel for the sessions we’ll be offering. This week, we spoke with our keynote speaker, Donna Smith, RHIA, senior consultant for 3M Health Information Systems, who will present, “Analyzing the Realistic Impact of ICD-10 on APR-DRGs.”

Q: Why is it critical for CDI professionals to understand how ICD-10 will affect APR-DRGs?

A: Historically, the focus has been on MS-DRGs. But, as more states switch to the APR system for their Medicaid population, it’s important to understand how it works. I will review the classification and explain how a patient might advance from one risk of mortality (ROM) and severity of illness (SOI) to another. I’ll also talk about, overall, what kind of changes and shifts were are going to see and how that will affect individual programs.

Q: How is your topic important for everyone in the CDI role, regardless of professional background?

A: Even if a state Medicaid program does not use APR-DRGS for payment, many organizations use the classification system to assess SOI/ROM. Most CDI specialists are interested in those scorings. Severity and risk are calculated a little differently with MS-DRGs. It changes how the case is paid and also indicates complexity of patient care. Both are interrelated and show how sick a patient is.

Q: As an RHIA, how does your perspective differ from other professionals performing the CDI role?

A: As a consultant, I see many different CDI programs. The best teams work as a group and have diverse backgrounds and experience in both nursing and coding. Personally, I bring the coding background. My clinical knowledge is good, and I can talk the talk. But the nurses are the ones who have the clinical understanding.

Q: What do you think is the most important quality for a CDI professional to have?

A: The number one thing is an interest in making sure that patients’ status or condition are accurately reported. That is their goal. They must interact and query physicians to get accurate documentation, so they can capture the clinical condition for a more accurate representation in either the MS or APR classification system.

Q: Why do you think attending the ACDIS conference is important?

A: I have been attending and speaking at the conference for a few years, and it has been really interesting to see the progression of ACDIS. CDI specialists can gain a lot of valuable information just by attending. I always enjoy going to the breakout sessions and finding out new information, and seeing how facilities are doing and how they are advancing their programs.

Conference Update: Speaker Q&A

Brown, Kyra

Kyra Brown, RHIA, CCS

The annual conference is just 34 days away. But don’t panic. We’re here to help you plan your schedule. As the countdown continues, we’ve spoken with Kyra Brown, RHIA, CCS, for a preview of her presentation “Coding of Complications: Past, Present, and Future.”

Q:  Why is coding complications relevant?    

A: Complications have become a “hot topic” in healthcare. You have to look back at the past in order to understand the present situation and the future of coding and documentation of complications. By looking at what’s previously been done, we can identify opportunities to improve and gain an understanding of why older data might incorrectly reflect higher complication rates.

Q: How is your topic important for everyone in the CDI role, regardless of professional background?  

A: One of the reasons I created this presentation was to provide thought-provoking content to lay the groundwork for dialogue between coders and CDI specialists. Coders and CDI specialists need to discuss the challenge of coding complications and the difficulties in obtaining documentation that supports code assignment.

Q: As an RHIA and CCS, how does your perspective differ from other professionals performing the CDI role?  

A: I started as an inpatient coder, an RHIT, then started teaching an RHIT program fulltime. In 2002, I started a CDI program, and since then have been one of the first Revenue Integrity auditors for my facility, and a corporate educator and auditor. Currently, I am a CDI manager and educator. My career path gives me a unique perspective, due to that diversity of working in many different roles. Each role provided me opportunities to learn and grow.

Q: How did you become interested in CDI? 

A: For me, it seemed like a natural progression. Even in my first role as an inpatient coder, we queried physicians and, as I progressed to teaching a DRG class that focused on coding and DRG assignment, to the next logical step was working with physicians to understand coding and documentation as it relates to reimbursement, severity of illness (SOI) and risk of mortality (ROM).

Q:  What do you think is the most important quality for a CDI professional to have?

A: The most important quality of a CDI professional is a passion to make a difference. Versatility and attention to detail are also important.

Q:  Why do you think attending the ACDIS conference is important?

A: This will be my fourth ACDIS conference and it is my educational event of choice. I always look forward to the sessions and learning something new.

Top 5 reasons you should attend the 2015 ACDIS Conference

Learn. Network. Succeed.

Here are the top 5 reasons why you should attend the 2015 ACDIS Conference:

  1. What you’ll learn is well worth the time
    In 2 and a half days, you’ll learn practical, actionable strategies to immediately improve your CDI program, resulting in better quality metrics and appropriate reimbursement.
  2. You’ll get to network with other CDI professionals… in San Antonio!
    Wouldn’t it be nice to trade stories and best practices with the top minds in CDI while strolling along the San Antonio River Walk, or at our pre-conference evening networking reception?
  3. Your professional value will grow
    Boosting your skills in 2015 will help you increase physician response rates, sharpen your queries, stay up-to-date with the latest regulations, and ultimately raise your professional value. You can even earn valuable credits for attending.
  4. Speaking of credit…
    This conference qualifies for up to 13 CCDS continuing education credits as well as 13 ANCC nursing contact hours,* in addition to CME and AHIMA and case management CEUs.
  5. Sessions are on the topics most important to you
    At this year’s conference you’ll find something for everyone in our four concurrent session tracks to choose from, including Management and Leadership, Clinical and Coding, Quality and Regulatory Initiatives, and Innovative CDI. See the sessions here.

For these reasons and many more, the 2015 ACDIS Conference continues to be the place CDI professionals come to learn, network, and succeed.

Click here for more information.

San Antonio, TX
May 19-21, 2015

Regular Rate – $1,005
ACDIS Member Rate – $905

 

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Conference Update: Journal special section; Speaker Q&A

acdisconference_largeIf you attended the 2014 ACDIS National Conference in Las Vegas, Nevada, then you know how wonderful it feels to suddenly be surrounded by hundreds of your peers, people who understand, and love, the same aspects of the profession as you. Take a look back at last year’s conference with a couple of special supplements and relive some of the highlights:

  • A slideshow video presents some of last year’s photo memories
  • Our Conference Special Section in the CDI Journal recaps some of the learning highlights, fetes our annual award winners, thanks our exhibitors and sponsors, and illustrates just how much fun an ACDIS conference can be.

To help you get revved up and rearing to go this year, we’re previewing a handful of speakers throughout the coming weeks to give you a feel for the sessions. This week, we spoke with Adelaide M. La Rosa, RN, BSN, CCDS, who, along with J. Peter Savini, BA, MHA will present “Revenue Cycle: Overview and Its Relationship to CDI.”

Q: Why is it important to understand the revenue cycle’s relationship with CDI?

A: As CDI specialists, our job is to make sure that whatever has been provided as care is accurately documented so it can appropriately translate to codes. When we put coding out there, we are determining the payment the hospital is entitled to and the DRG it is going to get. If we as CDI specialists are helping present the true overview of treatment and are capturing information, getting physicians engaged, and making sure there is complete coding, the end result will be long-term financial stability. Hospitals know expected revenues and plan budgets ad goals for what they need to do, and these budgets impact case mix and the patient population. It is important for CDI to understand that their day-to-day functions are part of what is driving the revenue cycle.

Q: How is your topic important for everyone in the CDI role, regardless of professional background?

A: There is a financial and clinical balance that must be taking place every day, and CDI needs to know what that means. They need to be aware of cash billed versus cash received and ask what patients we should be looking at to see additional opportunities. CDI specialists cannot just see themselves as simply getting diagnoses, CCs, and MCCs. They can play a significant role in finding a population of patients for review opportunities.

Q: As an RN, how does your perspective differ from other professionals performing the CDI role?

A: Having been on the floor as a nurse, I have communication skills to query physicians and the clinical background to understand what is going on. That clinical knowledge is very important. However, those without clinical experience, like coders, aren’t unfit for the job—but it does help expand how you would further review a chart.

Q: How did you become interested in CDI?

A: I did bedside nursing and floor nursing, and was always very driven about understanding when DRGs were coming into play and what that was all about. I was fascinated by the reimbursement aspect, too, and wanted to take my clinical knowledge and apply it to a different role. I may not be directly touching the patients with CDI, but there is an indirect impact, making sure the communication of care is clearly documented in the chart, so anyone picking up the chart can understand what’s going on.

Q: What are you most looking forward to at the ACDIS conference?

A: Meeting other professionals and networking. I’ve been doing this a long time, and am always interested in what else I can learn to grow as a leader, further enhance my clinical knowledge, and further understand the world. ACDIS does a great job of bringing a team of professionals together and offering them different breakouts that are great for new or experienced CDI professionals.

Conference Update: A look at last year; Speaker Q&A

Are you getting excited about the 2015 ACDIS Conference? Take a look back at this slideshow from last year’s conference:

To help you start planning your agenda for this year, we’re previewing a handful of speakers throughout the coming weeks to give you a feel for the sessions. This week, we spoke with Tamara A. Hicks, RN, BSN, MHA, CCS, CCDS, ACM, who, along with Melinda B. Matthews, RN, BSN, CCDS, will present “Welcome to Munchkin Land—the Land of Pediatric CDI.”

Q:  Why is pediatric CDI important right now? 

A: With ICD-10 looming, many CDI programs are expanding to all populations and all payers. Pediatric patients have their own CDI opportunities, and it takes specialized knowledge to be able to manage those cases.

Q: How is your topic important for everyone in the CDI role, regardless of professional background?

A: Pediatric patients aren’t just small adults. There are very specific conditions that CDI professionals must understand to be effective in pediatric CDI.

Q: As an RN, how does your perspective differ from other professionals performing the CDI role?

A: My communication with physicians is based on a clinical foundation. I’ve taken care of these patients, so I know what I’m reading in the medical record looks like and, many times, how the physician treats that type of patient. I’m able to anticipate what comes next for that patient. I initially got into CDI in 1999, shortly after completing my BSN, and I wanted to move away from bedside care and yet still use the education I had obtained. My goal join the case management profession, but when this opened up and I decided to give it a try. I was part of the initial team of CDI professionals in my organization. Today, I am managing case management, but CDI is my first love, and I continue to manage that team as well.

Q:  What do you think is the most important quality for a CDI professional to have?

A: Assertiveness. I tell people that CDI is no place for wallflowers. We must be able to challenge physicians in the way they think; we have to educate providers about documentation requirements; and we must be able to articulate coding guidelines to any audience

Q:  Why do you think attending the ACDIS conference is important?

A: Attending the ACDIS conference is an important way to network with others in the field. CDI is still a very new profession, so establishing best practice continues to be in its infancy. Those of us who have been in the field for a while must be a part of that. I’m most looking forward to learning more about what others are doing to expand their programs and how they are preparing for ICD-10.

2015 Conference Preview: Q&A with Karen Bridgeman

Do you know what sessions you’ll attend? The 2015 conference will be held in San Antonio, Texas.

Do you know what sessions you’ll attend? The 2015 conference will be held in San Antonio, Texas.

Editor’s Note: The annual conference is right around the corner, and we’ve got dozens of presentations in store. If you haven’t started planning your itinerary, we’ll preview a handful of speakers throughout the coming weeks to give you a feel for the sessions. This week, we spoke with Karen Bridgeman, MSN, RN, CCDS, who, along with Tina H. Smith, BSN, RN, CCDS, will present “Through the Looking Glass: Examining APR-DRGs in the Pediatric Population.”

Q: Why is pediatrics becoming an important component of CDI programs?

A: The MS-DRG, developed for reimbursement for the adult Medicare population, does not adequately meet the needs of the pediatric population. However, the APR-DRG was developed to meet some of the unique needs of the pediatric population. It also provides organizations the means to evaluate and compare quality measures. Medicaid insures more than 31 million children, including roughly half of all low-income children in the United States. As more and more state Medicaid programs use the APR-DRG system for reimbursement, CDI specialists need to understand how the APR-DRG system differs from the MS-DRG and how those differences affect their pediatric record reviews. 

Q: How is your topic important for everyone in the CDI role, regardless of professional background?

A: CDI specialists, coders, and physicians need to understand the importance of clinical documentation, not just on reimbursement, but how documentation affects quality metrics. Physician and hospital quality metrics are driven by the severity of illness and risk of mortality, captured by the APR-DRG ranking system so it’s important that we accurately capture specific diagnoses in the medical record. CDI programs can help improve a hospitals’ mortality index with improved capture of secondary diagnoses.

Q: As an RN, how does your perspective differ from other professionals performing the CDI role?

A: I bring my clinical knowledge into my reviews along with my confidence as a nurse in educating the physicians. Our coders often seek out our CDI nurses to verify their findings or seek clarification of the medical record. Having a good relationship with coders is essential. We rely on each other for expertise, mine in my clinical knowledge and theirs in the coding guidelines. We learn from each other.

Q: What do you think is the most important quality for a CDI professional to have?

A: Being able to take the initiative is probably the most important quality. Working independently, asking “why,” and seeking answers is essential for the CDI role. You must understand the clinical diagnosis and the pathophysiology, as that will help you look for secondary diagnoses, query opportunities, and provide a better understanding of the patient’s condition.

Q: Why do you think attending the ACDIS conference is important?

A: CDI specialists have limited resources to further our knowledge. We are a small niche, and relatively new profession. The wealth of knowledge shared at the conferences is invigorating, the speakers experts in their field, willing to sharing their knowledge and experiences. But, attending the ACDIS conference is more than listening to the speakers—it’s also about the networking, informal sharing of knowledge and practices. It’s fun to catch up with other CDI specialists that you only see at the conferences, listening to all the great experts, networking with other CDI staff, seeing some ‘old’ friends, and having some fun.

2015 Conference Preview: Q&A with David R. Jeffcoach, MD

ACDIS 001

Do you know what sessions you’ll attend? The 2015 conference will be held in San Antonio, Texas.

Editor’s Note: The annual conference is right around the corner, and we’ve got dozens of presentations in store. Even if you haven’t started planning your itinerary, we’ll be previewing a handful of our speakers throughout the upcoming weeks to help give you a feel for the session’s we’ll be offering. This week, we spoke with David R. Jeffcoach, MD, who, along with Trey A. La Charité, MD will present “The Impact of Targeted CDI Intervention on the Documentation Patterns of Surgery Residents: Can They Improve?”

Q: Why is it important to offer focused training for surgery residents?

A:  Clinical documentation has come to the forefront nationally with the implementation of the Affordable Care Act and “quality” healthcare delivery over “quantity.” Residents are at the forefront of healthcare delivery at teaching institutions and do the lion’s share of documentation, but very little is done to educate them on how they can make a difference. Surgery, being a chief source of revenue for most hospitals, stands to make a big impact. If we ignore our physicians in training patients, hospitals and the individual providers will suffer.

Q: Is your topic important for everyone in the CDI role, regardless of professional background?

A: Many people in the CDI sphere only interact with residents to get delinquent documentation resolved. At our institution, surgery lags behind most departments in their documentation competence. We hope to move the discussion into a proactive approach rather than purely reactive. What we hope to provide is an example of how focused training for residents can impact the whole system. I feel that knowledge of how physicians are trained with regards to CDI is important for everyone participating in CDI to understand, in order to better work together to make system improvements.

Q: How did you become interested in CDI?

A: Through speaking with my chairman, and the folks involved in CDI at my institution, I saw an opportunity to make a real impact on my fellow residents. I was mainly interested in surgical resident education, which led me to CDI. Though I am a new comer to the CDI table, I bring a fresh perspective and my experience as a physician in training. I have experienced the gaps in CDI training, and the opportunities that are available to reach physicians early. I hope to be able to educate others on what is being taught to physicians in medical school and residency and how we can make a difference.

Q: What do you think is the most important quality for a CDI professional to have?

A: Personally, I think once you know the basics of CDI, the most important quality is to be intentional.  As a provider, it’s hard in the daily challenges of clinical care to take time with each patient’s chart. Remembering to stay intentional and not missing a diagnosis, knowing it will have a direct effect on your patient’s care, has greatly improved my ability to document.

Q: Why do you think attending the ACDIS conference is important?

A: Simply put: collaboration. I’m excited to hear new ideas and speak with other people working on CDI nationally. I think ACDIS has the distinct advantage of collecting people involved in all aspects of CDI. Being able to exchange ideas and strategies between documentation specialists, physicians, and administrators is the best approach to make real lasting advancements in the field.

Conference Update: Call for poster presentations open

Share your CDI success with ACDIS conference attendees.

Share your CDI success with ACDIS conference attendees.

Have you thought about presenting a poster at the 2015 ACDIS conference in San Antonio? It’s a great opportunity to showcase your organization’s CDI program and success with a national audience. This popular event is always well-received by conference attendees. To give you an idea of what you might present, here is a partial list of topics from last year (you can view them in the Forms & Tools Library under “conference materials”):

  • Work flow, tracking processes, DG denials
  • Anatomy of an effective query
  • Documentation impact on quality, reimbursement
  • Pediatric-specific tip sheets per service line
  • Transforming from I-9 to I-10
  • Effective provider communication and education
  • Physician champions in urology
  • Malnutrition documentation
  • Charting query success
  • The value of ancillary services

Posters will be on display in the exhibit hall throughout the conference. Presenters are required to be on site for a dedicated time, one to two hours, to speak with conference attendees about their poster. Presenters may bring handouts, though these are not required.

We’ll take a photo of each poster and post it along with a one-page description (due from each presenter) on the ACDIS website following the conference.

To apply to present a poster in San Antonio, click this link, download the application, and return it by February 13. The conference committee will review the applications and select acceptable ideas for conference presentation. Limit, one poster per facility will be approved. Presenters receive a $200 discount off their conference registration fee (one discount per poster).

Email Penny Richards with questions.