AHIMA August 19, 2020
Collaboration between clinical documentation integrity (CDI) specialists and health information management (HIM) coding professionals is key to a successful CDI program as well as the evaluation of the revenue impact on the healthcare facility. When a CDI specialist’s final MS-DRG (or APR-DRG) does not agree with the coder’s final MS-DRG (or APR-DRG), then there is a “mismatch.” Many organizations struggle with finding a balance between these two teams, but with collaboration, communication, and education, there can be a significant revenue impact by performing mismatch reviews on a pre-bill concurrent basis.
Organizations need the appropriate data to accurately validate their CDI program as well as to account for their coder’s post-discharge pre-bill queries. This challenge goes hand in hand with trying...
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