Electronic Forms Team Minutes Blank



|Topic |Discussion |

|Welcome & Introduction |Welcome & Introduction to Pinnacle Health |

| |CDI program reports to HIM department and began in 2002 |

| |They have 13.5 FTEs who review All Payers at 3 hospitals |

| |Utilize OPTUM and EPIC |

| |39 participants present |

|Hot Topics |Outpatient CDI |

| |Reading Hospital began in the ED. CDI review emergency room records and they have designated time to sit in the ED and verbally communicate with the physicians.|

| | |

| |Penn State Health is starting outpatient CDI |

| |There are no set criteria for outpatient CDI. Many of the diagnoses are not CC/MCCs. |

| |Need to work with clinicians to allow them to see what is in it for them. |

| |For outpatient clinicians have to document a diagnosis at least once a year to avoid being penalized |

| |Palliative Care |

| |Effective October 1st 2016, CMS is now requiring Palliative Care code, Z515, to be classified as Present on Admission. Only when the palliative care code is |

| |classified as Y, 1, E, W would the code contribute to the patient’s expected values in applicable risk models. |

| |Sepsis |

| |Surviving Sepsis Guidelines were updated using Sepsis 2 definition |

| |Facilities are being audited based on Sepsis 3 criteria |

| |Audits |

| |Many facilities are short staffed and do not have the time to appeal cases |

| |Facilities should appeal cases by sending the medical record, outline information in chart from ancillary departments to help support why clinician documented |

| |and diagnosed the patient with a specific diagnosis, include support coding clinics & guidelines |

| |Makes the case stronger if the record is reviewed and appeal letter is signed by a Physician |

| |Clinical Validation audits are being done. Hospitals should be able to provide the most up to date literature and supporting documentation from the record |

| |MI Type 2 |

| |Coding Clinic 1st qtr 2017 - Type 2 MI due to demand ischemia is captured as NSTEMI and can be captured as principal or secondary dx depending on reason for |

| |admission |

| |Discussion of these patients being captured as a MI and failing core measures |

| |Physician Advisor / Champion |

| |Benefits of having a proactive physician advisor |

| |Assist with queries, escalation process, audits, education and much more |

|Speaker: Documentation Opportunities in TAVI/TAVR |Dr Hemel Gada |

|Population |Medical Director of Structural Heart Program |

| |Presentation included information on: |

| |Patients who receive TAVR |

| |Pathophysiology of AS |

| |Common CC/MCC associated within this population pre and postoperatively |

| |What Drives TAVR cost |

| |DRG 266 vs DRG 267 |

| |See powerpoint presentation |

|Business Meeting |Thanked E4 for supporting our chapter and sponsoring this meeting. They provided literature and lunch |

| |Topics suggested for future meetings – outpatient CDI, CDI/Coder Collaboration |

| |ACDIS Annual Conference will be in Las Vegas May 9-12 2017. A few people stated they will be attending |

| |Vote for Advisory Board for ACDIS. |

| |Gave away four prizes and E4 raffled off a $50 gift card |

| |Need a host for next meeting in June 2017 |

|Speaker: Improving Clinical Documentation through |Dr Douglas Anderson |

|Collaboration with Surgical Residency Program |Surgery Resident |

| |Presentation included information on: |

| |General Surgery resident role with CDI |

| |Communication system |

| |Escalation policy |

| |See powerpoint presentation |

|New Email / New Member Link |Please send all emails, questions, comments concerns to acdiscentralpa@ and also add to your address book to avoid emails being rejected. If you have a|

| |different email you would like to use please send so we can update the list |

| |If you know anyone that would like to become a member please have them complete this link to register: Electronic Membership Roster |

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