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Rules of the game

Rules of the game. Every table is a team. Share the ACDIS bingo cards with each other at your table. Every card at your table should be the same. Each table should select a team leader/secretary to be the official ACDIS bingo keeper. [CHANGE THESE RULE to FIT YOUR NEEDS].

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Rules of the game

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  1. Rules of the game • Every table is a team. • Share the ACDIS bingo cards with each other at your table. • Every card at your table should be the same. • Each table should select a team leader/secretary to be the official ACDIS bingo keeper. • [CHANGE THESE RULE to FIT YOUR NEEDS]

  2. Rules of the game (cont.) • The game caller, [PICK GAME LEADER], picks a “key word” and read several “clues” related to that “key word.” [LIST OF KEY WORDS on slide 5] • The players must identify the correct “key word” from the clues and mark it on their BINGO/ACDIS Card [http://print-bingo.com/bingo-cards-custom.php to create cards] with a pencil or pen. • When a team marks five in a row vertically, horizontally, or diagonally the team should shout “ACDIS!”

  3. Rules of the game (cont.) • Volunteers will verify your ACDIS bingo win and provide your table with a prize to share. • The first table to fill every square on the ACDIS bingo card will win [PICK SMALL PRIZES]. • Game play will continue until the first team covers its ACDIS bingo card or the time runs out.

  4. Has more than 3,000 members • Is a community in which CDI professionals share strategies for successful CDI programs and achieve professional growth • Its mission is to bring CDI specialists together

  5. There are more than 40 of these in the United States • The newest include pediatric/NICU and Critical Access Hospital Networks • Have more than 1,500 collective members

  6. Was first administered at the 2008 ACDIS Conference in Las Vegas • Now has more than 1,000 individuals with the designation • Is offered at 170 remote testing sites • Florida has the most certified individuals

  7. Where ACDIS members share sample query templates, physician education materials, and policies and procedures • Contains more than a 100 sample documents ACDIS members can adapt for their facility’s use • Where PowerPoint presentations from every ACDIS conference are stored

  8. Is known as a center of the music industry • Is the capitol of Tennessee • Is the location of the 2013 ACDIS National Conference • Is home of the Grand Ole Opry

  9. A tasty treat enjoyed as a child; often with a grilled cheese sandwich • A television show that aired on E! that showed funny clips of the previous day’s talk shows • Colloquial term for the collection of government auditors and CMS payment reporting agencies including, CERT (Comprehensive Error Rate Testing), ZPIC (Zone Program Integrity Contractors), MIC (Medicare Integrity Contractors), Recovery Auditors

  10. Divided into four regions: A, B, C and D • Perform post-payment and now, pre-payment reviews • Used to be called Recovery Auditors (formerly Recovery Audit Contractors [RACs])

  11. Not something you buy at McDonalds • Everyone who has Medicare patients has one of these • Medicare Administrative Contractors

  12. The opposite of salt • Not a vegetable • AKA: Program for Evaluating Payment Patterns Electronic Report

  13. CMS will not reimburse for care associated with these conditions • Took affect under the Deficit Reduction Act of 2006 • Hospital Acquired Conditions

  14. Endorsed by 43rd World Health Assembly in 1990. • The topic of a new two-day CDI Boot Camp • A medical classification list for coding of diseases, signs and symptoms, abnormal fin • Dings, complaints, social circumstances and external causes of injuries or diseases as mandated by WHO

  15. Commonly used indicators for intensity of hospital resource utilization. • The average diagnosis related group weight of all hospitals’ Medicare volume. • Under PPS, rather than costs, it is the most important factor in payment variations per case across hospitals.

  16. Presenting a question or seeking clarification to a physician regarding incomplete, conflicting, contrasting, nonspecific or the lack of clinical documentation • A communication tool used by coders and nurses who perform concurrent and retrospective review of the medical record to assign the most accurate ICD-9 code • Can be used as a physician/provider educational tool

  17. Allows for verbal queries to occur while patient treatment is on-going • Medical record review of inpatient admissions to identify incomplete, nonspecific, conflicting or contrasting documentation when there is no documentation, but clinical indications otherwise • It’s what we do

  18. Leverage to elicit physician/provider cooperation when publicly reported • Can be used as a performance evaluation tool for CDS • Is often reported to administration and monitored by the physician advisor

  19. What most CDI programs dream their physician query response rates could be • What most CFOs wish the CDI chart review rate for all payers could be • What the review rate for mortalities should be.

  20. According to AHIMA, these may be used as long as all clinically reasonable choices are listed, regardless of the impact on reimbursement or quality reporting • Choices should include an “other” option, with a line that allows the provider to add free text • Should include option of “unable to determine” • Should be designed to be as open ended as possible

  21. Is present in 55%–85% of patient cases • Query for related conditions such as obesity and cachexia • Work with dieticians to develop clinical indicators

  22. Inflammation of the lungs and airways to the lungs (bronchial tubes) from breathing in foreign material (incl. fluid). • Query for specificity when physician writes “possible aspiration”. • Infiltrate most likely to be seen in right upper lobe.

  23. The term used to describe inadequate gas exchange by the respiratory system • MS-DRG 189 • Typically develops with conditions such as COPD, pneumonia, severe heart failure, AIDS • Cannot be used interchangeably with “respiratory insufficiency”

  24. Definitely do not document urosepsis • A clinical syndrome that complicates severe infection • Represents the systemic response to an infection • Characterized by systemic inflammation and widespread tissue injury

  25. Echocardiogram shows an ejection fraction (EF) of less than 40%, indicative of systolic heart failure, or an EF of greater than 50%, generally indicative of diastolic heart failure • Look for evidence of decreasing EF and usage of home heart failure medications • Look for documentation of increasing doses of diuretics (e.g., physician order of “Lasix 40 IVP now” or “Increase Lasix to BID”). These orders may indicate treatment of an acute or acute-on-chronic episode of heart failure.

  26. May be caused by advanced and severe disease states, by infections, or medications • Main causes include: liver disease, kidney disease, and lack of oxygen to the brain due to infection • CDI specialists need to query for underlying infection

  27. One common symptom can be pain upon deep respiration. • Can be in the form of air, fat or blood-formed. • Confirmed by positive lung scan

  28. Sudden loss of kidneys ability to perform their main functions of eliminating excess electrolytes as well as waste materials from blood. • The goal of treatment is to restore kidney function and prevent fluid and wastes from building in the body. • Kidney or abdominal U/S is the preferred test for diagnosing this condition.

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