Rules of the game Every table is

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]

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-cardscustom. 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!”

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.

• 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

– 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

• 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

• 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 Power. Point presentations from every ACDIS conference are stored

• 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

• 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

• 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])

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

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

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

• Endorsed by 43 rd 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

• 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.

• 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

• 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

• 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

• 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.

• 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

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

• 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.

• 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”

• 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

$• Echocardiogram shows an ejection fraction (EF) of less than 40%, indicative of$

• 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-onchronic episode of heart failure.

• 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

• 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

• 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.