All Entries Tagged With: "Just for Fun"

Conference excitement: All that’s missing is ‘Jingle Bells’

ACDIS jingle bells. Anyone have suggestions for some CDI related lyrics?

It feels like the days leading up to Christmas to me. I just can’t wait to get to the ACDIS conference in San Diego.

I admit that part of the attraction is the chance to get out of the office for a few days, take a plane trip to a great city, and let someone else cook my meals and make the bed. I know my husband will miss me, but I’m confident he won’t starve in my absence.

But the real reason I can’t wait to get to the conference is to meet the people who are driven by such passion for the work they do as CDI professionals.

I joined the ACDIS team last fall, but have worked for the parent company for 12 years, mostly in the marketing department. I wrote promotional copy for ACDIS for years, including the launch pieces back in 2007. I assumed—probably like a lot of your non-CDI peers—that writing thorough, detailed documentation was a given and probably easily done. I couldn’t have been more wrong.

In my short tenure with ACDIS I’ve developed a new respect for the work CDI professionals do. I have a pretty good handle on the mechanics of my job as the member services specialist. I can help you get certified; stay certified; award CEUs for your chapter meetings; fine tune the language in applications, web posts, and handbooks; and chase down the glitches and hitches that complicate moments in a busy day.

Now it’s time for me to learn about CDI from your point of view. I want to build my understanding of how you do your job and understand the foundational knowledge you all have obtained through your experiences that make you vital to your facility’s success. I want to learn the rules and the guidelines, and how to apply them.

You’re with ACDIS so you can be the best CDI professional you can be. I’ve got a similar goal: to be your best support partner. Let’s give it our best shot.

The 5th Annual ACDIS Conference won’t be all work

We have some of the fun events planned for San Diego! If you have any questions, don’t hesitate to contact ACDIS members services specialist Penny Richards.  We look forward to seeing you there!

Poster Session: Starting Thursday morning, check out the 2012 Poster Session in the Elizabeth Foyer outside the exhibit hall. Twenty-three of your colleagues prepared posters detailing CDI programs, improvement strategies, and on specific topics such as queries, mortality, and physician engagement. You’ll find a ballot in your conference bag to vote for your favorite poster.

THURSDAY

Wear purple and orange today. ACDIS staff Brian Murphy, Melissa Varnavas, and Penny Richards have a surprise for some special conference attendees.

Breakfast: Kick start your morning with a continental breakfast as guests of MedPartners CDI.

Lunch: Join us for the annual awards luncheon where we’ll introduce the 2012 CDI Professional of the Year and the two winners of the 2012 Recognition of CDI Professional Achievement awards. The buffet-style luncheon is sponsored by Maxim Health Information Services.

Join CDI Search Group for a San Diego harbor cruise.

Evening: Following the day’s conference activities, exhibitor CDI Search Group will host a San Diego harbor boat cruise and dinner. Tickets for this event will be limited to 250 guests. To reserve your tickets, visit www.cdisearchgroup.com.  On their home page you’ll find a link to a brief survey to complete in order to receive your boarding pass and two drink tickets. Boarding is from 6:30 – 7 p.m. The cruise is from 7:45  – 8:45 p.m.

Evening: If you are from California and decide not to go on the cruise, join members of the California ACDIS Chapter at the ‘Top of the Hyatt’ for cocktails and snacks. It’s right in the hotel so you don’t have too far to go. They will gather beginning at 6:15 p.m. Please email gallanjt@sutterhealth.org if you plan to attend (to give the group a headcount).

A number of other local chapters will also be hosting after hours events. If you’d like to find out more, visit the ACDIS Local Chapter page and email the leader for your region.

FRIDAY

Early Morning: Weather permitting, ACDIS Member Services Specialist Penny Richards is going to climb into her walking shoes and take a morning stroll. Her destination is the Kissing Statue at Tuna Harbor near the USS Midway Museum—about a two-mile round-trip trek. More details to come at the conference.

Regional Spirit: Wear your ACDIS local chapter gear or something special that celebrates your hometown or region. For example, New Englanders are invited to wear Patriot’s or Red Sox gear and the FL ACDIS Chapter has created its own T-shirts and encourages attendees to don their Florida apparel.

Lunch: Join our California ACDIS hosts at the Local Chapter lunch. Pick up your box lunch in the exhibit hall and bring it to the main hall for an ACDIS Bingo game. (If you prefer, you may enjoy lunch in the hall with exhibitors or outside on the hotel decks). Participants will be asked a number of trivia questions that relate to squares on the bingo cards. You’ll compete for prizes with colleagues from your state/area. Meta Health Technology is our luncheon sponsor.

Ideas for fun in San Diego

Planning on going to San Diego to attend the fifth annual ACDIS conference (May 10-11)? There’s plenty to do in the city and if you can build some personal time into your trip, I’ve got a few suggestions for you.

The Gaslamp  District
The Gaslamp Quarter National Historic District is eight blocks long (from Broadway to Harbor Drive) by a little more than two blocks wide (4th, 5th, and 6th Avenues) for a total of 16 and one half blocks of shopping, dining, entertainment, and Victorian architecture excellence. It’s an easy walk from the conference hotel. Visit the web site, click on the link for coupons and enjoy discounts from some of the area merchants.

The Kissing Statue in San Diego is just one of the fun sights to see.

The Kissing Statue
The 25-foot tall, 6,000-pound sculpture is a rendition of the famous photo of the sailor kissing the nurse in Times Square in New York City at the end of World War II. It’s on loan to the city of San Diego and due to be replaced with a permanent painted bronze statue. At this writing, we’re not sure when the statue will be moved or when the new one will be installed, but look for it. And if your honey is with you, you can mimic the pose at the foot of the statue for your own photo to remember! It’s located at the foot of G Street and adjacent to the USS Midwest Aircraft Carrier Museum.

USS Midway Aircraft Carrier Museum
The USS Midway Museum is an unforgettable experience.  It’s an actual naval aircraft carrier that served in the United States Navy for 47 years.  Explore the exhibits, see restored aircraft on the flight deck, and take a self-guided audio tour that’s narrated by Midway sailors. Chat with docents who will share their stories about serving on board. Located on the harbor in downtown San Diego.

Old Town
Step back in time and visit beautiful Old Town San Diego, the birthplace of California. It’s right in the city and accessible by the Metropolitan Transit System. You’ll find historic sites and parks, wonderful shops and restaurants. This is a “don’t miss” for history buffs.

The San Diego Zoo
Travel from the savannah to the arctic at the San Diego Zoo. The zoo features animals from A (armadillos) to Z (zebras), including pandas, koalas, jaguars, wallaby, and wild dogs. View five species of eagles (including the bald eagle), as well as gila monsters, komodo dragons, and Panamanian golden frogs. Wear your walking shoes or take the in-park trolley. The zoo is located inside Balboa Park and you can access from the Metropolitan Transit System.

Balboa Park
A beautiful park with gardens and walking trails, museums  (including Air & Space Museum, Auto Museum and the Natural History Museum),and the San Diego Zoo. You can access the park from the Metropolitan Transit System

Hotel del Coranado
The Del is the most magnificent and elegant place I’ve ever visited. When I was there a few years ago, I watched a fashion photography shoot on the beach. Built more than 120 years ago, The Del has been visited by princes, Presidents, and Hollywood elite, and has served as the backdrop for movies and books (such as Some Like It Hot, which starred Marilyn Monroe, Jack Lemmon, and Tony Curtis; The Stunt Man, which starred Peter O’Toole; Wicked, Wicked, which was completely filmed on location there, and the 1990 version of My Blue Heaven, with Steve Martin and Rick Moranis). I’m going to visit The Del and I’d love to have you come along! We’ll take the ferry across the bay and then hop a bus to our destination. Oh, I almost forgot to mention: The Del is rumored to be haunted.

The San Diego Padres at Petco Park
The Padres will be in town on Monday-Wednesday May 7-9, playing the Colorado Rockies. Monday’s and Tuesday’s games begin at 7:05 p.m.; Wednesday’s game has a 12:35 p.m. first pitch.

Public transportation
San Diego has a great public transportation system to help you get around the city and enjoy the sights.

Need more ideas?
Talk to a San Diego local. Ask the front desk staff at the hotel for their suggestions about places to visit, where to shop, and where to get a great meal. You know that business web sites tout theirs as “The Best in the City”. The locals really know where to go to find the hidden jewels that will make your visit to San Diego one to remember.

You can also visit the region’s official travel resource at www.sandiego.org/nav/Visitors.

I’m looking forward to not only a great conference but visiting all the sights and sounds of San Diego and I hope you enjoy them as well!

Happy Friday the 13th

Don't be scare of ICD-10 codes for phobia.

Editor’s Note: Sure, most CDI professionals won’t be submitting queries to physicians about what scares their patients most. Nevertheless, this post from our friends over at the ICD-10 Trainer Blog raised the hairs on the back of our necks, so we thought you might enjoy a little Friday the 13th, ICD-10 coding fright, too.

Do you suffer from triskaidekaphobia, paraskevidekatriaphobia or friggatriskaidekaphobia? In other words are you afraid of the number 13 or Friday the 13^th? More importantly, can you code for those fears?

Surprisingly, ICD-10-CM does not have a specific code for the fear of the number 13 (triskaidekaphobia) or fear of Friday the 13^th (paraskevidekatriaphobia or friggatriskaidekaphobia). If your physician documents any of these phobias, you would report ICD-10-CM code F40.298 (other specified phobia). So even though the code doesn’t specify the phobia, the documentation does.

If the physician documents a generic phobia, but doesn’t say what the patient is specifically afraid of, you would have to default to the unspecified code F40.9 (phobic anxiety disorder, unspecified). Of course before you do that, you should query the physician. Maybe you’ll find out your patient is really afraid of injections and transfusions (F40.231), small spaces (F40.240), or spiders (F40.210).

So don’t break any mirrors or walk under any ladders today and absolutely, positively avoid black cats. If you believe in that bad luck stuff that is.

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.

Everything I need to know I learned from my cat

My cat Thomas as a kitten. Isn't he adorable?

Nobody reads blog bios. But if you read mine, you’ll see mention of Thomas, one of my four cats. I keep his picture as my work computer’s background, and because I have dual screens, I get to look at him twice.

Thomas and I have a lot in common: We’re old. We’re gray. At least one of us doesn’t look a day over 45.  And we know what we like. There are a few things we don’t have in common: He doesn’t like the New York Giants nearly as much as I do, and I don’t lick empty plastic bags very often. (Why do cats do that?)  But I adore him completely, because he brings me joy. So I thought I’d try to discover if any of Tommy’s endearing characteristics could be adapted to my role as a CDI specialist.

• Always inquisitive. It seems like cats never take things at face value. They always have to investigate things for themselves. They are always pouncing off to figure out what made some small sound, pushing their noses into some half opened cupboard door. As a CDI specialist, you have to have this same type of inquisitive nature to look into all the detailed information and push to gain access to other documentation such as nurses’ or dieticians’ notes to help you understand the complete clinical picture.
• Purring when he’s happy. Although I speak pretty fluent cat, and rarely am in doubt as to whether Tom and his fellow cats are due for lunch, most of the time I still have to rely rather heavily on Tom’s nonverbal signals. Cats purr and put their tails straight up when they’re happy; they present themselves in a vulnerable position when they’re open to affection. An interesting phenomenon, though, is that cats also purr when they are heavily stressed. If you don’t evaluate the situation, you won’t interpret their mood correctly. Learn to read your physicians’ signals. Smiling and nodding could be positive signals, or they could be polite ways of trying to get rid of you. Always consider the context of your interactions.
• Marking his favorite human. Yes, that would be me. Cats nuzzle their humans not just for the physical contact, but also to mark the human as their personal (cat-onal?) property using their scent glands. The marking is irrelevant to me, but the contact is precious. And when Tommy rubs his head against me and tells me I’m his favorite human, of course I want to return the attention. Your physicians probably don’t spend much time thinking about you, so when you make contact with them, make it memorable. Let them know they are genuinely appreciated, not only for their documentation skills, but for being great doctors, and even great human beings (when applicable). You might reap some unexpected benefits.
• Being a cat means never having to say you’re sorry. Well, okay, of course if we screw up, we should apologize. But cats don’t feel guilt, at least as far as I can tell. If you yell at them for scratching your sofa, they might skulk for about three seconds, but then they move on. If you keep yelling at them, they’re only going to avoid you, because they’ve already forgotten about the incident and don’t understand why you’re acting out. So when you make a CDI mistake, deal with it and move on. Many nurses have been conditioned to strive for perfection and are used to being chastised when they (of course) fail to be perfect. The word “perfect”  in my opinion has no place in healthcare.  Setting standards is good; setting unrealistic standards is a recipe for failure.

My work environment would be just about ideal if I could review charts with Thomas sitting on my lap. He’s just so darned cute, and he’s also a great typist.

Florida Chapter founding leader remembers group’s begining

Early on the Florida ACDIS Chapter developed its own logo.

By Kimberly A. Richert, RN, CCDS

I started the Florida ACDIS Chapter back in 2009. There were only 15 chapters in the country then. Now there are nearly 40. At the time I was a lead CDI specialist for Morton Plant Mease (MPM) Healthcare system in Clearwater, Fl.  After attending my first ACDIS conference that spring in Las Vegas, I knew I had to get the CDI specialists and programs in our state involved. After attending that first conference, I realized that our area of expertise (CDI) was BIG and that it was only going to get BIGGER.

There was great support from our upper management in the Morton Plant Mease Hospital  which allowed us to move forward with our dream. (Thank You, Clare Garrard, RN, DSN, manager of the CDI department, for allowing this to happen!) The CDI team at MPM’s Clearwater facility started making phone calls to other local facilities to see if they had anyone of this specialty in their system. It turned out that Tampa General’s CDI program was up, trying to run with the CDI concept, and form their department.  A few more phone calls and we found CDI teams at St. Anthony’s hospital in St. Petersburg and Tampa General Hospital.

We had enough interested participants to hold a meeting and form the Florida ACDIS Chapter.  We held our inaugural meeting at my facility. There were 17 participants from diverse backgrounds including RNs, coders, and physicians. Click on this link to listen to that meeting in its entirety.

After that we formalized our structure and elected a president, vice president, and secretary/treasurer. Now our

Several participants in an ACDIS Florida Chapter meeting donned floppy hats to celebrate the Kentucky Derby.

membership has increased to nearly 100 participants from all over our great state. We hold quarterly conferences that typically take place on either a Friday or a Saturday at a different host facility each time. We have held meetings as far north as the Florida panhandle at Sacred Heart Hospital in Pensacola and as far south as Jupiter, at the Jupiter Medical Center. We typically decide on a “meeting theme” to add to the enjoyment of the event. Participants have enjoyed wearing hats for “Kentucky Derby Day,” masks for Halloween, even grass skirts for a luau.

While our chapter members like to enjoy themselves, our main purpose is to provide a collegial venue for networking, a space to provide information and education to the CDI specialists and related professions working in the Florida region. Our goal is to provide a cohesive bond between CDI specialists in diverse hospitals and clinical settings throughout Florida and provide advocacy for the CDI role. Since its inaugural meeting, we have been fortunate enough to offer presentations regarding RAC efforts, denials, transition to ICD-10, compliant query creation, electronic queries, and so much more.

In the beginning, there was no nationally recognized credential on which we could tout our experience and expertise in the CDI role. Since the creation of the Certified Clinical Documentation Specialist (CCDS) credential, however, most of the Florida ACDIS members have become certified. Congratulations to those who now have the CCDS behind their names! We are so proud of you!

And big kudos to all of you who have helped to start and sustain this wonderful chapter. Thank you, to those who continue to support this chapter throughout each year. You are the ones who keep us going.

As our Florida ACDIS Chapter grows we hope to keep communication open between individuals working in this new and expanding field and to have the collaboration with all other departments involved. We hope to see you out on the floors or at one of our upcoming meetings!

Editor’s Note: For information about the Florida ACDIS Chapter visit its website at http://flacdis.org/ or visit the Local Chapter page on the ACDIS National site www.acdis.org.

‘As God as my witness’ there’s a query opportunity here

Can you begin to imagine how complex a piece of great literature would be in we had to include complete documentation

Chasing documentation down like Rhett Butler after Scarlet O'Hara?

of each medical incident? Or have to stop every time we have to develop physician queries?

Let’s take a look at the classic tale Gone with the Wind and see whether we can identify some areas where author Margaret Mitchell might have given us more information.

• Scarlett O’Hara’s first husband Charles Hamilton dies of pneumonia. Viral? Bacterial? What was the treatment plan?
• Countless soldiers are wounded and dying in makeshift hospitals. Are there coding concerns about where the injuries occurred, specifically with regard to which state the patient resides in (as the bills may go to different fiscal intermediaries)? What about POA or the possibility of readmission?
• Scarlett learns her mother is ill but because of the war, Scarlett can’t get home to see her mother. Might Scarlett be experiencing stress and anxiety?
• Melanie Wilkes gives birth to a baby boy, Beau. No physician is present for the delivery. Can we assume a physician saw mother and child for post-delivery examination?
• Scarlett finds that her father Gerald has lost his mind. Is there a diagnosis of dementia or Alzheimer’s? Is it post traumatic stress disorder or due to an injury suffered during the war?
• Gerald dies of injuries from a fall off a horse. Do we need to indicate where the event took place?
• Ashley Wilkes is shot in the retaliation attack. Where was the wound? What procedures were performed?
• Frank is killed in that same attack. Poor Frank. He really thought Scarlett loved him. Poor Suellen who never stopped carrying a torch for him. She was likely given a sedative and put to bed. Injection? Infusion? Shot of brandy?
• Scarlet marries Rhett Butler and has his baby. Are there any complications noted?
• Scarlett, pregnant again, falls down a flight of stairs and miscarries. What is the trimester? Does she suffer injuries in addition to the lost pregnancy? What drugs are administered for her injuries? Is there a plan for physician follow up? Are any specialists called in for consultation? Did she fall or was she pushed?
• Their daughter, Bonnie Blue, falls from her horse and dies of her injuries. What is the actual cause of death and how should her other injuries (if there were any) be noted in the record?
• Melanie is ill, suffers a fall, and never recovers. She dies. Did she fall due to the illness or injuries from the fall? What conditions were present on admission to the good doctor’s care?
• Ashley has a broken heart. How should this be documented for appropriate coding?
• Rhett walks out on Scarlett. She weeps and then pulls herself together and declares that tomorrow is another day. Does anything indicate that Scarlett may be suffering from delusions? The vapors?

What do you think? Do you have any other suggestions for movies or literature that we could probe for clinical documentation opportunities?

Reminder: Eight tips for social media etiquette

Does the social medial world sometimes make your head spin? Here are some simple tips to help you.

Do you mix your personal and professional lives on your Facebook page? I separate my personal and professional relationships on Facebook. My personal life is just that, and I don’t need or wish to share some things with my professional associates. There’s nothing randy, more like exchanges with my 20-something nephews, girly gossip about fashion and martinis, or grumblings about local politics. I don’t play Farmville (and have no patience for such postings), don’t care about daily horoscopes, or 99% of posted YouTube videos.

These posts don’t belong on professional pages. Facebook gives us a fabulous opportunity to network on the topics that bind us as colleagues. We can share ideas, techniques, and processes. We can ask one another for advice and guidance.  We can commiserate with our cyber friends about our jobs and careers, encourage those who undertaking new challenges, and cheer for those who achieve their goals.

Most Facebook pages are open to the public, which means your comments, posts, and pictures are searchable. You need to be very careful about what you say and post on Facebook—or on any social media platform, whether on a personal or professional page.

I found a Facebook etiquette list published by the Association of Women’s Health, Obstetric, and Neonatal Nurses and got their permission to adapt it here as recommendations for our association’s interactivity on our social networking sites including Facebook, LinkedIn, CDI Talk, and soon (believe it or not) Twitter.

Consider these tips for smart social media conduct:

1. Be respectful of people’s comments. If you don’t agree with a comment, state your point without being rude, confrontational, disrespectful, angry, or vulgar. Better still, don’t reply at all.
2. When you post a comment, ask a question, or respond to others, give your opinion about important topics in a professional manner.
3.  Remember HIPAA – don’t post patient information in ANY form. Don’t post particulars about a patient or a situation that might be identified. Don’t post photos of patients.
4. Share articles from reputable sources that you believe will educate your peers on different topics. Take a page from Glenn Krauss and Lynne Spryszak who frequently share links to government auditors’ transmittals on the ACDIS Facebook page.
5. Be careful how you express an opinion about your current facility, work, or a co-worker. Remember that your managers and co-workers are also interested in these CDI professional networking opportunities and may be members themselves. Don’t forget that your employer and/or future employer could view what you have posted. Don’t divulge confidential and/or proprietary information and don’t spread gossip. If you would not want them misconstruing your conversation if they overheard it in the hallway, don’t put it on the Internet either.
6. If you choose to post pictures, select those that are in good taste. If a photo of a friend is unflattering (and you’d be horrified to see that image of yourself posted for all to see) don’t post it.
7.  Don’t spam. Some people like to eat it (believe it or not) with fried eggs, but reposting advertising or promotional materials to social networking sites isn’t good etiquette.
8. Ask questions of your peers and participate in Wall or Discussion Boards regarding a specific topic. Share your expertise when you can, and thank those from whom you take suggestions.

Note: This list was adapted and reprinted with permission from the Association of Women’s Health, Obstetric, and Neonatal Nurses, www.awhonn.org. For

Santa’s not the only one watching to see if you’ve been bad or good

Singing: He sees you when you’re sleeping. He knows when you’re awake. He knows if you’ve been bad or

What will the jolly old elf will bring to the RAC offices?

good, so be good for goodness sake.

Remind you of anyone? No? Here’s a hint. It rhymes with knick-knack but these groups aren’t known to be particularly “nice.”

Audit contractors (Recovery Audit Contractors or RACs) are not Santa, but they are watching you, and they certainly know if you’ve been naughty.

Let’s be realistic, all of your facility healthcare data is being scrutinized, analyzed, and compared. Statistical data gives audit contractors an idea of which hospitals fall off the bell curve, and what diagnosis qualify as low hanging fruit.

If your hospital has a 30% sepsis admission rate and all other hospitals in your area have a 10% rate, then you pretty much are going to stand out like a sore thumb. Do not fool yourselves. It is not because your CDI department is that much better at capturing sepsis as a diagnosis.

Take a look at how your facility does business and whether it may be pushing the envelope when it comes to leading queries and creative coding. Does your hospital follow AHIMA’s recommendations when it comes to formulating compliant queries?  The brief clearly states that:

“Individuals who perform the query function should be familiar with the AHIMA Standards of Ethical Coding, which direct coders to assign and report only the codes and data that are clearly and consistently supported by health record documentation in accordance with applicable code set and abstraction conventions, rules, and guidelines.”

Next, review and update your own internal policies and procedures. Many hospitals create these policies and then never check to make sure the rules are being followed. The AHIMA guidance states:

“Individuals performing the query function should follow their healthcare entity’s internal policies related to documentation, querying, coding, and compliance, keeping in mind that data accuracy and integrity are fundamental HIM values. Only diagnosis codes that are clearly and consistently supported by provider documentation should be assigned and reported. A query should be initiated when there is conflicting, incomplete, or ambiguous documentation in the health record or additional information is needed for correct assignment of the POA indicator.”

Lastly, create an audit process to ensure that both your own policies and AHIMA recommendations are being followed. Healthcare entities should consider establishing an auditing and monitoring program as a means to improve their query processes. They can consider several methods for this ongoing process. Queries can be reviewed retrospectively to ensure that they are completed according to documented policies. This might include reviewing determining whether the:

• query was necessary
• language used in the query was not leading or otherwise inappropriate
• query introduced new information not otherwise included in the medical record

Based on the results of this review, the healthcare entity may need to identify specific corrective actions. For example, any cases identified as containing inappropriate queries which resulted in inaccurate code assignment will require corrective action and possibly rebilling. Inappropriate queries should be tracked, trends identified, and appropriate education, training, and/or disciplinary action taken when warranted.

No one wants to get a lump of coal in their stocking. And no one wants to give the RAC or other auditor a Christmas bonus. Take time this holiday season to make some New Year resolutions and ensure that your facility is compliant and knowledgeable. You will then reap the rewards of a stocking filled with peace of mind.