by Melissa Varnavas

I was looking through old drafts of blog posts and came upon some notes from ACDIS blogger Linda Renee Brown. She wrote that sometimes CDI professionals look for expert advice and that once they identify it, they follow it to the letter.

But “What’s an expert?” she asked, and went on to quote an old teacher who broke the term down into its component parts stating that a “ex is a has-been and a spurt is a drip under pressure.” Clearly the teacher (and Brown) meant that anyone can self-describe as an expert but its up to us as individuals to do the extra research and ensure that the advice provided is actually sound.

The ACDIS Advisory Board created the following white paper which analyzes national survey data on CDI specialists' chart review productivity and lists the variables that can reduce or enhance that productivity. The white paper provides ACDIS’ recommendations on chart review productivity standards.

The overwhelming majority of the 414 respondents to the CDI Productivity Survey (99%) indicated that most CDI duties revolve around concurrent  medical record review and the provider query process.

Ninety percent of respondents post queries (paper or electronic), 79% ask verbal queries, and 76% perform query follow-up. About 65% also spend some amount of time conducting DRG reconciliation. These are the principal review tasks conducted by CDSs.

Improper hospital claims dropped from $10.45 billion to $4.42 billion from the 2014 report period (July 1, 2012 to June 30, 2013) to the 2016 report period (July 1, 2014 to June 30, 2015), according to a recent post on CMS Blog.

The agency attributes the decreases to policy decisions regarding inpatient versus outpatient care as well as to intensive probe audit reviews and educational efforts on documentation and billing practices.

Allowing hospitals to bill for Part B services in instances when inpatient admissions were deemed “not to be reasonable and necessary,” helped facilities rebill appropriately, wrote Shantanu Agrawal, MD, deputy administrator and director for Center for Program Integrity, and Jennifer Main, director and chief financial officer for Office of Financial Management, in the Blog post. 

Out of roughly 3,000 hospitals across the country, more than 1,600 will have an increase in their base operating MS-DRG payments, according to a CMS November 1 release, regarding the fiscal year (FY) 2017 results of its Hospital Value-Based Purchasing (VBP) program.

Funding for value-based incentive efforts increased for FY 2017, from 1.75% to 2% of base operating MS-DRG payment amounts—to approximately $1.8 billion in total—for all participating hospitals.

ACDIS is excited to announce that it is accepting applications for poster presenters at its 10th Annual Conference, to be held May 9-12, 2017, at the MGM Grand Hotel in Las Vegas. This is a great opportunity for hospitals and other CDI professionals to promote their CDI programs and share them with a national audience.

Posters may describe an innovative program process or department expansion, a CDI success story, or an obstacle your team overcame. Posters may not promote a product or service. If you are interested in presenting a poster, click this link to submit your idea: http://app.keysurvey.com/f/1084930/5a39/

Join ACDIS Director Brian Murphy for the final two ACDIS Radio programs of 2016 on Wednesday, December 14, at 11:30 a.m., eastern for a case study of the CDI program at LifePoint Health "Standardizing CDI across 60+ facilities" and on Wednesday, December 28 for a discussion of the new ACDIS White Paper regarding CDI Productivity with member of the ACDIS Advisory Board.

To register for these free bi-weekly programs, click here.

Throughout the past few months, the ACDIS administration has been fortunate enough to visit with a number of local CDI professionals from Cape Code to North Carolina and to speak with CDI staff around the country. You’ll hear from many of them throughout this edition of the CDI Journal.