How can CDI benefit practices as ICD-10 date approaches?

The transition to ICD-10 includes several changes to practice procedures and workflow. Clinical documentation improvement is becoming increasingly important as the implementation date edges closer, making these alterations easier and producing extra revenue for many providers.

How to increase reimbursement rates
According to HealthITAnalytics, many health care professionals are concerned about their ability to achieve enhanced revenue cycle management and improve reimbursement rates. According to Mandy Rogers of Summit Healthcare Regional Medical Center, CDI has the potential to cover both areas of concern while accounting for large financial gains. 

"About a year and a half ago, we decided that with all the changes coming from Medicare and the recovery audit contractors, we needed to be a little bit more defensive about our money that was going in and out," Rogers told HealthITAnalytics. "So we decided to start a CDI program from the ground up about a year ago."

Rogers explained that with the coming of the ICD-10, changes to the hospital's documentation would alter its diagnoses-related groups, which could have ended up having a significant impact on them. In order to get a major complicating condition, or MCC, she focused on enhancing clinical documentation and searched for a CDI vendor that would help the hospital plug gaps in its revenue cycle. After struggling to find one that was willing to work with a small organization, Rogers found one that allowed them to quickly jump into improvement efforts. 

CDI proves beneficial
Summit accomplished significant revenue gains after only four months of working with physicians and coders to improve all aspects of their clinical documentation. The hospital has achieved over $550,000 in positive financial impact after raising the case mix by 20 percent, increasing complicating condition capture and MCC by 22.8 percent and 37 percent, respectively.

Tackling the project from a revenue cycle management standpoint has enabled providers and the CDI team to work together in an effective way. However, Rogers does credit ICD-10 for influencing the hospital to make the decision to invest in CDI.