Course Provider
Learning Objectives
Define payment methodologies beyond Medicares inpatient prospective payment system (IPPS), including the Hierarchical Condition Categories (HCC) system
Describe the potential advantages and documentation opportunities of expanding CDI beyond MS-DRG review/optimization and CC/MCC capture
Explain the impact of principal diagnosis assignment (i.e., diagnosis sequencing) on indirect revenue, including that affected by quality metrics and medical necessity denials
Define the CDI specialists role in supporting medical necessity and working collaboratively with utilization review/case management
Develop documentation strategies to enhance a hospitals quality metrics without compromising data integrity congruent with official coding guidelines
Describe how additional CDI responsibilities impact individual metrics, including staffing, productivity, and workflow
Discuss how physician documentation impacts various quality metrics through coded data, compared to abstracted data and surveillance data
Conduct reviews and/or develop appropriate review processes to ensure accurate reporting of Patient Safety Indicator (PSI) 90
Develop strategies to leverage collaboration within the revenue cycle, including CDI, coding, infection control, quality, and case management (utilization review) to promote consistency in the reporting of metrics associated with Hospital Value-Based Purchasing (HVBP) and other quality indicators