The Physician Advisor’s Role in CDI Boot Camp (ACDIS Pre-conference)

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The Physician Advisor’s Role in CDI Boot Camp (ACDIS Pre-conference)

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PRE-CONFERENCE

The Physician Advisor’s Role in CDI Boot Camp

May 20-21, 2018 - San Antonio (8:00 a.m. to 5:00 p.m. each day)

The Physician Advisor’s Role in CDI Boot Camp returns to the 11th annual ACDIS Conference with a new format and agenda. 

Attendees will receive a half-day of instruction on the critical coding, clinical, and regulatory changes to the CDI profession over the past year, delivered by Nashville-based regulatory guru James S. Kennedy, MD, CCS, CCDS, CDIP. Learn about the new 2019 IPPS rule, the impending changes to the MS-DRG CC/MCC structure beginning on October 1, 2018, the MACRA/MIPS cost efficiency models (which use CMS-HCCs and other ICD-10-CM not part of CMS-HCCs), ICD-10’s impact on mortality, readmission, and complications methodologies, Coding Clinic concepts amendable to CDI, and other principles in this jam packed 4-hour session. 

The second half of day 1 is a denials workshop led by Trey LaCharité, MD, of the University of Tennessee Medical Center in Knoxville who will walk through his experiences with the Recovery Auditor program and discuss actual denied cases and appeals letters. A good CDI physician advisor not only knows the code and the law, he or she knows the judge and the jury, and Dr. LaCharité will outline what works and what doesn’t work in advocating a facility’s relationship with payers and recovery auditors. 

Attendees then can select their choice of session on day 2: Our popular Physician Advisor 101 by LaCharité’, which reviews the nuts and bolts of being an effective physician advisor, or a brand-new case study presentation by Nicole Fox, MD, Associate Chief Medical Officer at Cooper University Health Care in Camden, New Jersey. Fox will discuss cutting-edge changes to her CDI department including expansion into the ambulatory setting, remote CDI, and point of entry CDI. 

Cancellation Policy
Please click here to view our cancellation policy.

Full Agenda

Day 1: Sunday, May 20 

Registration and breakfast 
7:00 a.m. – 8:00 a.m. 


Critical CDI Update: Top Plate Issues requiring Immediate Attention

8:00 a.m. – 10:00 a.m.

  • Top changes in the ICD-10-CM/PCS Index, Table, Guidelines, Coding Clinic, and proposed IPPS rule warranting physician attention 
  • Potential changes to the CC/MCC list announced in the April 2019 IPPS rule with recommendations for comments due in June 2018 
  • Clinical definitions affecting CDI workflow (e.g. updated definition of myocardial injury and myocardial infarction; evolution of sepsis-2 to sepsis-3) 


Break
10:00 a.m. – 10:15 a.m.


Impact of ICD-10-CM/PCS on Mortality/Readmission/Quality Calculation

10:15 a.m. – 11:00 a.m.

  • How inpatient and outpatient ICD-10-CM codes affect mortality/readmission/ complication measures 


Outpatient CDI fundamentals
11:00 a.m. – 12:00 p.m. 

  • Outpatient rules and their differences with inpatient 
  • Fundamentals of CMS-HCC and HHS-HCC risk adjustment 
  • Fundamentals of MACRA/MIPS risk adjustment for episode-based cost efficiency 


Lunch (provided) 
12:00 p.m. – 1:30 p.m.


Man the Barricades! Today’s Recovery Auditor Reality

1:30 p.m. – 3:00 p.m.

  • Why the CDI PA should care about recovery auditors 
  • Why your facility is a recovery auditor target 
  • Learn the specific recovery auditor tactics employed to issue denials 
  • Preventing recovery auditors from issuing future denials 


Break
3:00 p.m. – 3:15 p.m.


Stopping the Hemorrhage: Strategies for Appealing Recovery Auditor Denials

3:15 p.m. – 4:45 p.m.

  • How to approach and fight a recovery auditor denial 
  • Review the most common clinical validation denials 
  • Approaches and resources for appealing disease-specific clinical validation denials 
  • Understand and avoid the double jeopardy that Medicare patients represent in recovery auditing efforts 


Open Q&A
4:45 p.m. – 5:00 p.m. 


Adjourn

5:00 p.m.


Day 2: Monday, May 21 

Continental breakfast
7:00 a.m.–8:00 a.m.

(Choose 1 of the following 2 tracks)

Track 1: Physician Advisor 101: Core Skills and Responsibilities 

Breakfast
7:00 a.m. – 8:00 a.m. 


Achieving Medical Staff Buy-in

8:00 a.m. – 9:00 a.m.

  • How to explain the goals of your CDI program 
  • What your providers don’t know about their documentation and their data 
  • What your providers don’t know about your facility 
  • How to explain why CDI is crucial for the future of your providers and your facility 


Ready, Set, Intervene! Managing Problems, Pitfalls, and Personality Disorders
9:00 a.m. – 10:00 a.m.

  • Understanding the obstacles you and your program will face 
  • 10 rules for ensuring CDI program success 
  • Strategies to improve medical staff compliance 
  • Practical suggestions for that difficult provider conversation 


Break

10:00 a.m. – 10:15 a.m.


Timing is Everything: How and When to Query

10:15 a.m. – 11:00 a.m.

  • Construct an appropriate and compliant query process 
  • Understand the routine documentation problems encountered by your coders and CDS personnel 
  • Case examples of challenging records created by poor provider documentation habits 


Stop, Drop, and Roll! Managing the Unexpected Fires
11:00 a.m. – 12:00 p.m. 

  • The impact of your CDI program on other hospital departments 
  • Review EMR-specific risks for CDI 
  • Handling other unanticipated problems 


Lunch (provided)
12:00 p.m. – 1:30 p.m.


Practical Considerations: CDI Team Structure and PA Position Development

1:30 p.m. – 3:00 p.m.

  • CDI team composition and getting them up to speed 
  • The other roles of the active CDI physician advisor 
  • Who should be your CDI program’s physician advisor? 
  • Successful CDI physician advisor characteristics 
  • Physician advisor time requirements and getting paid 


Break
3:00 p.m. – 3:15 p.m.


CDI: Not just for Inpatients Anymore

3:15 p.m. – 4:30 p.m:

  • Why you need to take CDI to your outpatient practices 
  • What your PCPs don’t understand about their performance metrics 
  • What are HCCs, why they are important, and how to capture them 
  • Basic building blocks for the creation of a successful outpatient CDI program 


Open Q&A 
4:30 p.m. – 5:00 p.m.


Adjourn

5:00 p.m. 


Track 2: Cooper University Health Care: CDI Case Study 

Breakfast
7:00 a.m. – 8:00 a.m. 


Playing to Win: Clinician Engagement with CDI

8:00 a.m. – 9:15 a.m.

  • How to engage clinicians in CDI 
  • Common obstacles and pitfalls 
  • Understanding clinician workflow 
  • Achieving the “100%” response rate to queries 


Thinking Outside the Box: The Hybrid CDI model
9:15 a.m. – 10:00 a.m.

  • Designing the program 
  • Hiring remote CDS’s 
  • Management of CDI from “afar” 
  • Integrating the hybrid team 
  • Tools for success 


Break
10:00 a.m. – 10:15 a.m.


Expanding the Role: PSIs, HACs and more

10:15 a.m. – 11:15 a.m. 

  • Implementing comprehensive review of PSI’s, HACs and more 
  • Physician engagement and education 
  • Compliance issues and oversight 
  • How to handle conflict (coders/CDI/compliance) 


The CMI is Down!!! Call C-D-I (and other emergent requests)
11:15 a.m. – 12:00 p.m.

  • The CDI program’s impact on other departments 
  • Revenue cycle opportunities 
  • Prioritizing the needs of your organization 
  • Keeping your CDI team engaged during a crisis 


Lunch (provided)
12:00 p.m. – 1:30 p.m.


It’s All About the … Metrics

1:30 p.m. – 2:15 p.m.

  • Metrics to gauge program success 
  • Venues to present metrics (high-visibility) 
  • Justifying growth and expansion of your team 
  • Making a “business case” for expanding CDI services 


Beyond the Walls: Building an Ambulatory CDI Program
2:15 p.m. – 3:00 p.m. 

  • Building the case for CDI in the physician practice and hospital ambulatory settings 
  • Ambulatory review workflow and CDI responsibilities 
  • How to provide assistance and oversight of E/M services 
  • Designing physician education in the ambulatory setting 


Break
3:00 p.m. – 3:15 p.m.


Point of Entry CDI: Another Frontier

3:15 p.m. - 4:30 p.m. 

  • Benefits of point of entry CDI 
  • Getting started 
  • Ensuring physician engagement with CDI 
  • Navigating the relationship between CDI and utilization review 


Open Q&A
4:30 p.m. – 5:00 p.m


Adjourn

5:00 p.m.


*Agenda subject to change

Learning Objectives

At the conclusion of the course, participants will be able to: 

  • Explain the roles and responsibilities of a physician advisor to CDI 
  • Describe the most problematic terms in ICD-10-CM/PCS and best practice for resolving coding versus clinical disagreement 
  • Identify common problem areas and deficiencies in medical records and physician documentation 
  • Construct optimal techniques for engaging physicians in a CDI program 
  • Develop best practices for capturing documentation in the hospital's workflow 
  • Develop methods for building credibility with medical staff and peers 
  • Develop methods for maintaining compliance with various industry audit and payment agencies 
  • Identify how coded data is used for physician and hospital profiling and quality initiatives 
  • Identify areas of opportunity for CDI in the outpatient setting 
  • Identify new growth areas for your CDI department including point of entry CDI and remote CDI 

Continuing Education

CE Credit information coming soon!


Disclosure Statement
HCPro has confirmed that none of the faculty/presenters, planners, or contributors have any relevant financial relationships to disclose related to the content of this educational activity.

Faculty

  • James S. Kennedy, MD, CCS, CDIP, CCDS, is the founder and President of CDIMD, a Nashville-based physician and facility advisory and consulting firm that advocates ICD-10-pertinent clinical documentation and coding integrity essential to healthcare revenue cycles and quality measurement. He teaches The Physician Advisor’s Role in CDI Boot Camp year-round and is a former ACDIS advisory board member. 
  • Nicole Fox, MD, MPH, FACS, CPE, is Associate Chief Medical Officer, medical director of CDI and pediatric trauma at Cooper University Hospital in Camden, New Jersey. After receiving her medical degree from UMDNJ (now Rutgers) and a master’s in public health/health administration from the Rutgers School of Public Health, she trained in general surgery at Christiana Care. She then completed her fellowship training in surgical care at Cooper University Hospital. Currently, Fox leads a team of 13 RN CDI specialists who have achieved a 100% physician response rate to queries. 
  • Trey La Charité, MD, FACP, CCDS, is the medical director for clinical documentation integrity (CDI) and coding at the University of Tennessee Medical Center (UTMC) in Knoxville, Tennessee. Before joining his current position in 2008, he was a member of the Association of Clinical Documentation Improvement Specialists (ACDIS) advisory board. He is a regular presenter at the ACDIS pre-conference physician advisor boot camp. 

Event Site and Hotel Information

ACDIS Conference and Pre-Conference Boot Camps will be held May 20-24 at:
The Henry B. Gonzalez Convention Center
900 East Market Street
San Antonio, TX 78205  

Contracted hotels that we have a discounted hotel block with:

San Antonio Marriott Riverwalk Hotel
889 E Market
San Antonio, TX, 78205 


San Antonio Marriott Rivercenter
101 Bowie Street
San Antonio, TX,  78205 


Hyatt Regency San Antonio Riverwalk
123 Losoya Street
San Antonio, TX 78205  


La Quinta Inn & Suites
San Antonio Riverwalk
303 Blum St.
San Antonio, Texas 78205 

  • Room rate $159/night
  • Hotel cut-off date is Friday, April 20, 2018
  • Toll-Free Reservations Center: 866-527-1498 opt. #1
    • Hotel: La Quinta Inns & Suites San Antonio Riverwalk (property #0501)
    • Group Name: ACDIS 2018 Annual Conference
  • Or reservation requests can be emailed to lq0501sc3@laquinta.com
  •  Hotel website: www.laquintasanantonioriverwalk.com


Hilton Palacio Del Rio
200 South Alamo
San Antonio, TX 78205