Countdown to ICD-10
When it comes to ICD-10 implementation efforts, clinical documentation improvement (CDI) continues to be one of the most pressing concerns on the minds of healthcare providers. For some, the recent ICD-10 delay announcement couldn't come at a better time.
ICD-10 isn't just a "coder" problem. With industry analysts predicting 50-70% productivity losses due to ICD-10, the development of complete and accurate CDI program will be critical to smooth transition. As reimbursement, revenue, compliance and care management are all at risk, the impact of a quality CDI program within ICD-10 implementation efforts shouldn't be underestimated.
With the increased level of specificity due to ICD-10, provider documentation will need to accurately pinpoint elements such as severity of illness, laterality, complications, episodes and stages, and symptom etiology. This means major impacts to not only coders, but physicians as well.
With this in mind, physician champions can help act as liaisons to help physicians understand their role and impact on reimbursement and patient care. Physicians and coders alike will play a critical role in the accurately capturing DRG data, with the potential to also capture thousands in previously unrealized revenue.
What are the keys to gaining clear, concise documentation through an effective CDI program?
A CDI program will need to:
- Promote medical necessity documentation to support admission, readmission, and therapies, treatments and procedures.
- Ensure accurate and complete documentation for accurate coding and reimbursement, including an accurate case mix index (CDI), correct payments and reduced compliance risk, and the correct identification of the principal and/or secondary diagnoses, MCCs and CCs.
- Align with Joint Commission and Conditions of Participation regulations
- Support evidence-based care for quality reporting measures
Overall, communication will be key. CDI staff will need to analyze data, formulate physician queries, track CDI program performance, and successfully communicate with physicians, administration, HIM staff and others.
On the road to ICD-10, how does your CDI program measure up?