CDI for Outpatient Boot Camp

Course Overview

Premier outpatient education from the most trusted name in CDI

The CDI for Outpatient Boot Camp is the go-to source for outpatient CDI professionals and those seeking to begin a CDI program in the outpatient arena. This Boot Camp has been created by the trusted experts at HCPro and ACDIS.

This course defines the various roles of CDI specialists in the outpatient arena, provides comprehensive training, and applies ACDIS-endorsed best practices.

The CDI for Outpatient Boot Camp provides tools for CDI professionals to practice in the outpatient setting and maximize the impact of CDI functions. Because outpatient CDI is still in its early stages, ACDIS is taking the lead in defining roles, suggesting focus areas, and establishing standards and core competencies, all of which are covered in this course. The Boot Camp examines diagnoses impacting Hierarchical Condition Categories (HCC), record review and query, medical necessity documentation, CDI's role in charge capture, and ethics and compliance.

CDI in the outpatient setting encompasses a variety of focuses, including ED, observation, primary care, and ambulatory care. The regulatory landscape and best practices are rapidly evolving, and organizations must work to stay effective and compliant.

You'll leave the CDI for Outpatient Boot Camp with a complete understanding of:

• How to apply the Official Guidelines for Coding and Reporting in the outpatient setting
• How to conduct record reviews
• Compliant query practices in the outpatient setting
• Risk adjustment and Risk Adjustment Data Validation (RADV) audits
• Common diagnoses of focus in the outpatient setting
• The process and focus of provider education

The CDI for Outpatient Boot Camp will help you:

• Implement a step-by-step process for thorough medical record review based on industry guidelines for the outpatient arena
• Develop compliant verbal and written physician queries and understand how to effectively query providers in the outpatient setting
• Recognize conditions in the outpatient setting that are a common focus for review, such as HIV disease, neoplasms, diabetes, malnutrition, morbid obesity, substance abuse/dependence, major depressive disorder, chronic obstructive pulmonary disease, chronic respiratory failure, quadriplegia, paraplegia, hemiplegia, heart failure, cardiomyopathy, angina, chronic kidney disease, pressure ulcers, chronic wounds, and status codes

What sets the CDI for Outpatient Boot Camp apart? See the difference for yourself!
Check out all the benefits of this HCPro Boot Camp:

• Expertly designed course materials: Course materials are developed by an adult education expert. The curriculum uses a “how to” approach where participants learn how to apply CDI concepts that they can then customize to their organizational needs. Content is regularly updated based on changing industry practices and participant feedback.
• Live instruction: Classes are taught by an experienced instructor who is credentialed as a CDI professional and works as an industry subject matter expert for ACDIS.
• Small class size: We limit the number of course participants in order to maintain a low participant-teacher ratio. This allows us to provide individual instruction as needed when participants find a topic particularly challenging; it also allows time for discussion.
• Well-established program: Brought to you by the Association of Clinical Documentation Integrity Specialists (ACDIS), this Boot Camp from the industry's only dedicated CDI association provides the best-in-class education you expect.

Our Boot Camps are a comprehensive and effective way to strengthen your understanding of CDI. “Our goal as instructors is to offer detailed, thorough, and timely education that can be simply broken down and easily understood and applied in daily practice,” says Deanne Wilk, CDI education director at HCPro.

ACDIS members save $150 off the registration fee. Call 800-650-6787 to receive your special discount rate or sign up to become an ACDIS member today!

CCDS-O examination information
ACDIS offers a certification for outpatient CDI specialists, the Certified Clinical Documentation Specialist-Outpatient (CCDS-O) credential. We recommend the CCDS-O exam for individuals who complete this Boot Camp, meet the exam eligibility criteria, and desire to pursue certification. However, the course may not cover all the content areas tested on the exam. Consequently, depending on your background and experience, you may need to undergo additional independent study and/or training to pass the CCDS-O examination. To download the CCDS-O Exam Candidate Handbook and view the prerequisites for taking the exam, or to download an application form, visit the ACDIS website at https://acdis.org/certification/ccds-o.

For more detailed information about our Boot Camps, contact us at 615-724-7200 or email sales@hcpro.com.

Looking to train your whole team? We can bring our expert instructors to you! Learn more here!

CDI for Outpatient Boot Camp

Course Outline

Module 1: Introduction to Outpatient CDI: The Basics

This module discusses the evolution of CDI from the inpatient to the outpatient setting. It reviews the roles of CDI and coding professionals related to medical record review and provider education. The module also reviews the ICD‐10‐CM, Healthcare Common Procedure Coding System (HCPCS), and Current Procedural Terminology® (CPT®) code sets.

Learning Objectives:

• Define the role of documentation within the health record
• Identify the roles of CDI and coding professionals
• Distinguish what documentation can be used to report a code from those whose documentation can only be used as clinical indicators of a condition
• Apply the ICD‐10‐CM and HCPCS/CPT code sets to daily record reviews

Module 2: The Official Guidelines for Coding and Reporting

This module reviews the Official Guidelines for Coding and Reporting for ICD‐10‐CM diagnosis reporting with a focus on Section IV: Diagnostic Coding and Reporting Guidelines for Outpatient Services. The module reviews basic code assignment, coding conventions, and regulatory guidance such as AHA Coding Clinic®.

Learning Objectives:

• Explain when the Official Guidelines for Coding and Reporting are updated and where to obtain official information
• Apply AHA Coding Clinic  advice in code assignment
• Apply the principles of first-listed diagnosis selection
• Apply the guidance contained in Section IV: Diagnostic Coding and Reporting Guidelines for Outpatient Services

Module 3: Healthcare Reimbursement

This module offers a review of healthcare reimbursement methodologies, including fee-for-service, value based, and shared risk. The overview compares the Inpatient Prospective Payment System (IPPS) and the Outpatient Prospective Payment System (OPPS).

Learning Objectives:

• Compare and contrast the following healthcare reimbursement methodologies:
• Fee-for-service
• Value based
• Shared risk
• Compare and contrast the IPPS and OPPS

Module 4: Record Review and Compliant Queries

This module addresses core functions of CDI: record review and compliant query practice. It reviews the principles of record reviews in the outpatient setting and reviews the 2022 AHIMA/ACDIS guidance related to compliant query practice.

Learning Objectives:

• Understand the role of a query in CDI/coding
• Identify the available guidance on when and how to query based on professional industry standards
• Incorporate industry guidance in the construction of simple queries
• Define the query process and understand the basic elements that an organization’s query policy should address

Module 5: Risk Adjustment

This module reviews key concepts of risk adjustment with a focus on CMS Hierarchical Condition Categories (HCC). Discussion includes review of demographic and diagnosis considerations, disease interactions, documentation opportunities, risk score calculation, and Risk Adjustment Data Validation (RADV) audits.

Learning Objectives:

• Apply risk adjustment concepts to daily CDI record review
• Compare and contrast the models used in risk adjustment
• Compute the Risk Adjustment Factor (RAF) score for example individuals
• Describe the process of RADV audits

Module 6: Anatomy and Physiology

This module reviews diagnoses and conditions that are a common focus in CDI outpatient reviews. Conditions include: HIV disease, neoplasms, diabetes, malnutrition, morbid obesity, substance abuse/dependence, major depressive disorder, chronic obstructive pulmonary disease, chronic respiratory failure, quadriplegia, paraplegia, hemiplegia, heart failure, cardiomyopathy, angina, chronic kidney disease, pressure ulcers, chronic wounds, and status codes.

Learning Objectives:

• Discuss diagnoses and conditions that are a common focus in CDI outpatient reviews
• Identify opportunities for query and provider education in the outpatient setting
• Apply Official Guidelines for Coding and Reporting and AHA Coding Clinic instruction appropriately and accurately
• Discuss diagnostic guidelines and apply clinical validation

Module 7: Evaluation and Management (E/M): Professional Services Billing

This module discusses the basic documentation requirements of E/M coding as defined in the 1995 and 1997 Documentation Guidelines for Evaluation and Management Services. It also covers the changes in requirements that went into effect in 2021.

Learning Objectives:

• Distinguish between new and established patients
• Explain the concept of relative value units
• Evaluate the required documentation components for all E/M levels
• Develop CDI process efforts to assist with E/M leveling

Module 8: Quality Reporting

This module reviews quality reporting measures that impact providers in the outpatient setting, such as the Healthcare Effectiveness Data and Information Set (HEDIS), the Medicare Access and CHIP Reauthorization Act (MACRA), and the Merit-based Incentive Payment System (MIPS). The discussion also covers Alternative Payment Models (APM) incorporating risk and quality, such as Accountable Care Organizations (ACO) and patient-/family-centered medical homes.

Learning Objectives:

• Incorporate HEDIS measure concepts within daily CDI functions
• Identify areas monitored within HEDIS measures
• Teach concepts related to MACRA and MIPS reporting to providers
• Communicate the impact of CDI functions on the above quality measures

Module 9: Outpatient CDI Function in Charge Capture

This module discusses the function of CDI in the outpatient setting related to charge capture. It discusses activities related to denials management and medical necessity of care, such as work related to National and Local Coverage Determinations (NCD/LCD). The module also discusses charge capture related to observation charges, injections/infusions, and the chargemaster.

Learning Objectives:

• Introduce CDI functions to the process of denials management
• Apply NCD/LCD requirements to daily CDI practice in record review
• Discuss reimbursement related to observation status and how CDI can assist with accurate capture 
• Define the chargemaster and functions to manage charge practices 

Module 10: Physician Engagement and Education

This module reviews CDI activities related to physician engagement and education.

Learning Objectives:

• Identify challenges related to provider education in the outpatient setting
• Develop a provider education plan
• Identify key concepts to include in provider education
• Design educational strategies to successfully communicate concepts

Module 11: CDI Metrics, Ethics, and Compliance

This module discusses common metrics used to measure and communicate the impact of CDI efforts. It reviews efforts to minimize vulnerability and covers the functions of government audit agencies, the Office of Inspector General (OIG), and the False Claims Act (FCA). The module also reviews the ACDIS Code of Ethics.

Learning Objectives:

• Design metric reports to measure CDI impact
• Apply the ACDIS Code of Ethics to daily CDI practice
• Describe the function and focus of the following audit initiatives
• Comprehensive Error Rate Testing (CERT)
• Recovery Auditors (RA)
• Program Safeguard Contractors (PSC) and Zone Program Integrity Contractors (ZPIC)
• Office of Inspector General (OIG)
• Medicare Administrative Contractors (MAC)
• Commercial audits
• RADV audits

Module 12: CCDS‐O Exam Preparation

This module ends the course with a discussion of the CCDS‐O exam, prioritizing preparation needs and the test-taking experience. 

*Agenda is subject to change.

CDI for Outpatient Boot Camp

Learning Outcomes

At the conclusion of this educational activity, participants will be able to:

• Create a step-by-step process for thorough medical record review based on industry guidelines for the outpatient arena
• Develop compliant verbal and written queries to effectively query providers in the outpatient setting
• Recognize conditions in the outpatient setting that are a common focus for review, such as HIV disease, neoplasms, diabetes, malnutrition, morbid obesity, substance abuse/dependence, major depressive disorder, chronic obstructive pulmonary disease, chronic respiratory failure, quadriplegia, paraplegia, hemiplegia, heart failure, cardiomyopathy, angina, chronic kidney disease, pressure ulcers, chronic wounds, and status codes

Continuing Education

AAPC
This program has prior approval of the AAPC for 21 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the AAPC of the program, content or the program sponsor.

ACDIS
This program has been approved for 21 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification and CCDS-O (outpatient) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).

AHIMA
This program has been approved for continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting of Approved CEUs from AHIMA does not constitute endorsement of the program content or its program provider.

ANCC
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 21 nursing contact hours is provided by HCPro.

CDI for Outpatient Boot Camp

Things to Know Before Attending Class

Directions and Hotel Information

The hotel address, phone number, URL, room rate and room rate cut-off date are posted on the Locations/Dates tab. The hotel websites give detailed directions to the hotel as well as information about the location. Please call the hotel directly to make a room reservation. Be sure to identify yourself as an HCPro Boot Camp participant. Please be sure to make your reservation before the cut-off date. After the cut-off date, contact the hotel to determine room availability and rates.

Course Materials

When you arrive at class, you will receive two books containing the class materials utilized throughout the boot camp. These books will be yours to keep, so plan accordingly in allowing enough room in your luggage on the return trip home. The books weight approximately 5 pounds. Books may also be shipped from the hotel at your own expense.

Classroom Time

Other than short breaks and lunch, we will be in class from 8:00 a.m. to at least 5:00 p.m. each day. In order to focus all attention on the course and to not distract other participants as well as the instructor, cell phone use during class is strictly prohibited. We will take short breaks (up to 10 minutes each) throughout the day that will give participants an opportunity to make calls, use the restroom, etc., in addition to an hour lunch break for lunch on your own.

Lunch

We will take about a 45-minute break for lunch each day. We typically provide coffee in the morning and drinks and a light snack in the afternoon, everyone is on their own for lunch. Note that many hotels do not have restaurants on-site. If you are flying to the course, we generally recommend renting a car, or investigating availability of hotel shuttle or ride share.

What to Bring to Class

Please bring the following to all classes:

• Highlighter
• Notepaper
• Sticky Notes/flags
• Pen/Pencil
• Layered clothing (e.g., light sweater, light jacket, etc.)

Dress

Business attire is not necessary. Please dress comfortably. Sometimes classrooms are on the cool side, even during the warmer months. You may be more comfortable if you bring a sweater or sweatshirt in case you get cold.

CCDS Examination Information

The Association of Clinical Documentation Improvement Specialists (ACDIS) offers a certification for CDI specialists, the Certified Clinical Documentation Specialist (CCDS-O). We recommend the CCDS-O exam for individuals who desire to pursue certification. However, the course may not cover all the content areas tested on the exam. Additionally, the certification requires experience performing the duties of a CDI specialist so attending this class may not qualify you to sit for the exam if you are new to the field of CDI.

Consequently, depending on your background and experience, additional independent study and/or training may be required to pass the CCDS examination. To download the CCDS Candidate Handbook and Application and view the prerequisites, visit the ACDIS website at https://acdis.org/certification/ccds-o.

Cancellation and Transfer Policy

For our cancellation and transfer policy, visit our website: http://hcmarketplace.com/cancellations

COVID Safety

Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

• If the region where our event is located is deemed by the CDC to be within the substantial or high-risk category, we will require all attendees, regardless of vaccination status, to wear masks when indoors except while actively eating or drinking. 
• Meeting rooms will be set to support social distancing when necessary.
• Food service will follow the safety guidelines implemented by the hotel.

To view all the safety measures that a specific hotel has implemented, please see the information listed on their website.

Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines, and will communicate adjustments to the onsite policies and procedures as necessary.

Contact Information

For more information about our Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

We Look Forward to Having You In Class!

CDI for Outpatient Boot Camp

Questions/Answers

What is the focus of the CDI for Outpatient Boot Camp?
The CDI for Outpatient Boot Camp is a three-day, classroom-based intensive training course that will teach outpatient CDI and coding specialists the skills necessary to succeed in their jobs. It focuses on:

• Common diagnoses impacting Hierarchical Condition Categories (HCC)
• Record review and query
• Medical necessity documentation
• CDI role in charge capture
• Ethics and compliance

The CDI for Outpatient Boot Camp will also benefit organizations with established outpatient CDI programs that need additional development.

Where is the course offered?
Open registration courses are offered at various locations around the country, typically at mid-priced business hotels such as Hyatt Place or Hilton Garden Inn. For a current schedule of upcoming open registration courses, click on "Course Locations/Dates". In addition to our open registration courses, we also offer the CDI for Outpatient Boot Camp as an on-site course (with a substantial discount) for organizations that have a number of employees who need training. For more information on hosting an on-site course at your facility, call 800-650-6787 or email customerservice@hcpro.com. In addition, we offer the CDI for Outpatient Boot Camp online.

What if I need to cancel or transfer my registration?
To view our cancellation policy, click here.

What material does the course cover?
To view the course outline, click on "Course Outline" above.

Does the course require any previous experience or training?
No. However, because of the course’s fast-paced nature, it is recommended (but not required) that participants have at least one year of experience working in a CDI or coding position. This course is taught on a basic to intermediate level.

Who should attend?

• CDI specialists
• CDI managers/directors
• Coding compliance directors/managers
• Coding compliance specialists
• Outpatient coders
• HIM directors
• Revenue cycle directors
• Physician champions/advisors to CDI
• Quality improvement professionals
• Coding managers/supervisors
• Denials and appeals managers
• Compliance officers

Is there a discount for ACDIS members?
Yes. ACDIS members save $150 off the registration fee. Call 800-650-6787 to receive your discount or click here for more information.

How is the course taught?
The course is taught using a combination of lecture and class discussion.

What do I need to bring to class?

• Highlighter
• Sticky notes
• Pen/pencil

Does HCPro ever share contact information (e.g., name, address, phone number, email address, etc.) with other companies?
Historically, we have not shared contact information with anyone outside of our company. However, it is possible that at some point we might share contact information with other companies that offer products and services that we think would be of interest to our customers. If you would like us to keep your contact information confidential, please let us know so that we can flag your information in our customer database as "Do Not Share."

How do I get more information?
Contact us at 615-724-7200 or email sales@hcpro.com.