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Coding and CDI, both critically important to the success of our healthcare institutions, will continue to evolve in response to changes in technology, reimbursement, and workforce requirements. The relationship between CDIs and Coders is changing as the Revenue Cycle function requires a team approach that embraces all operational areas that impact revenue. We asked seven experts what they thought about the intersection of CDI and coding and what it means to them and their organization.
In the third installment of this discussion, several of the experts discuss CDI challenges that they’ve recently faced. (See the series in its entirety here.)
ERAMO: What’s the biggest challenge you’ve encountered in the last week?
TROMBLEY: I’m in the process of learning more about E/M coding and CPT guidelines so I can help train and audit other outpatient CDI specialists. CDI has traditionally focused on inpatient only, so E/M coding isn’t something with which many CDI specialists have experience.
“Provider documentation is the biggest challenge—getting providers to buy into CDI and provide quality documentation. This was the same challenge ten years ago when I started in the profession.”
-Trey La Charite
LA CHARITE: Provider documentation is the biggest challenge—getting providers to buy into CDI and provide quality documentation. This was the same challenge ten years ago when I started in the profession. I don’t think this is something that CDI specialists can fix unfortunately. It’s more of an administration problem. Administrators must talk to the medical staff and convey the importance of documentation.
LAFRAMBOISE: Keeping up with the pace of change is the biggest challenge. RNs come from a profession that changes slowly. The human body doesn’t change. But CDI changes so rapidly. We have an opportunity to impact value-based payments and our ranking in U.S. News & World Report—so we keep pushing the envelope to do these things.
Lisa A. Eramo, MA, moderator and freelance writer
Leif Laframboise, RN, CCS, CDI professional with more than 20 years of healthcare experience who currently works for an academic medical center in the northeast
Nikki Miskowicz, RN, BSN, CCDS, manager of clinical documentation integrity at Stanford Children’s Health
Rayellen Kishbach, director of customer success at MediRegs, a division of Wolters Kluwer Law& Business
Tammy Trombley, RHIT, CDIP, CCDS, compliance manager at HCTec, a coding, auditing, and CDI service provider
Trey La Charite, MD, FACP, SFHM, CCS, CCDS, medical director of clinical documentation integrity and coding at the University of Tennessee Medical Center
Mary Beth York, CCS, CCS-P, CIC, senior associate at Barry Libman, Inc., a coding and auditing company
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