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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 seventh installment of this discussion, participants are asked for their experience in joint education for CDIs and coders. (See the series in its entirety here.)
ERAMO: Is joint education beneficial for coders and CDI specialists? If so, what topics could benefit both roles?
MISKOWITZ: I think joint education is a good idea. We provide our coders and CDI specialists with access to the same online learning modules that focus on major diagnostic categories, including conditions and applicable codes within those categories.
LAFRAMBOISE: We’ve turned all of our education into joint sessions. Coders can attend CDI sessions to learn more about clinical topics and vice versa. It’s a great opportunity to share information and collaborate. Previous topics include respiratory failure, encephalopathy, AKI, hemodynamics, shock, and sepsis. We focus on the clinical indicators, and what must be documented for accurate code assignment. We also touch on relevant guidelines and coding clinics.
Joint education is so important. When there’s a conflict between CDI and coding, it stems from a lack of understanding the other’s perspective. Joint education can help staff understand that even though we’re all reading the same documentation, CDI looks through a clinical lens while coding looks through a guidelines/conventions lens. The interpretations can be very different because of this.
TROMBLEY: We provide joint education about annual coding updates, new coding clinics, and clinical indicators for query opportunities.
YORK: I don’t recommend joint education because coding and CDI are two distinct functions. You need to tailor content accordingly.
LA CHARITE: We provide a joint two-hour educational program quarterly. The first hour is spent reviewing problematic diagnoses and procedures from a medical perspective, and the second hour is spent reviewing coding mistakes that external auditors found.
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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