The Essential CDI Guide to Provider Queries

The Essential CDI Guide to Provider Queries
Marion Kruse, BSN, RN, MBA
Jennifer Cavagnac, CCDS

The Essential CDI Guide to Provider Queries is the authoritative source for defining policies, procedures, and best practices for provider queries.

Thanks to ICD-10-CM/PCS implementation, as well as the advancement of electronic health records and electronic query systems, CDI programs are being pushed in challenging new directions--requiring CDI specialists to redefine where and how they generate queries. Meanwhile, CDI program managers need innovative solutions to improve their query process, target high-risk diagnoses, and educate delinquent providers, coders, or CDI professionals.

The Essential CDI Guide to Provider Queries is the only resource that provides a comprehensive analysis of query guidelines and easy-to-follow strategies to improve your processes.

Using the tools provided in this vital guide, you can update your practices to meet the challenges of ICD-10-CM/PCS, government payer initiatives, auditor denials, and electronic initiatives.

With sample queries, policies, procedures, and national benchmarking data included, The Essential CDI Guide to Provider Queries is a valuable addition to your CDI library.

You'll also find information on:

• ICD-10 implementation
• Recovery Auditors process
• Electronic health records
• Electronic query efforts
• Compliance risks and OIG scrutiny

TABLE OF CONTENTS
Chapter 1: Healthcare Reimbursement Initiatives
Chapter 2: Regulatory Environment
Chapter 3: Coding Advancements
Chapter 4: Query Guidance Progression
Chapter 5: The Query Process
Chapter 6: Electronic Health Records and the Advancement of eQueries
Chapter 7: Query Assessments, Program Auditing, and Education Opportunities

BONUS TOOLS
Sample query policies and procedures, sample processes for eQuery review, sample DRG reconciliation process, sample queries for common ICD-10-CM/PCS difficulties, sample queries related to recent query practice recommendations in Guidelines for Achieving a Compliant Query Practice.

WHO SHOULD READ THIS?

• Clinical documentation Improvement manager/director
• Clinical documentation integrity manager/director
• HIM manager/director
• Case management manager/director
• Director of revenue Cycle
• CDI specialist
• Quality manager