Pediatric CDI Foundations

Pediatric CDI Foundations

Reviewed by Leah N. Savage, MSN, RN, CCDS

Pediatric disease processes don’t always mimic those seen in the adult population. This makes expanding CDI reviews to pediatric units or children’s hospitals a challenge, but every challenge is an opportunity.

Previously titled Pediatric CDI: Building Blocks for Success, the newly revised Pediatric CDI Foundations provides an in-depth look at a variety of documentation concerns specific to childhood conditions. Whether you need help securing administrative support from the get-go or want guidance on delving deep into the documentation depths, this book provides the foundational knowledge needed to get your pediatric program off the ground.

A must-read for both new and experienced CDI specialists engaged in pediatric chart review, Pediatric CDI Foundations addresses the following key topics:

• Basic tenants for establishing a pediatric CDI program

• Pathophysiology fundamentals for pediatric diagnoses including congenital heart conditions, developmental diagnoses, nutritional and gastroenterological conditions, respiratory conditions, and more

• Coding and documentation requirements for common pediatric diagnoses

• Techniques for gaining pediatric physician support

• Methods for tracking and trending program success

Use this book to expand into the pediatric setting or to take your existing pediatric CDI efforts forward and improve documentation, coding, quality, and reimbursement.

Table of Contents

Introduction

Chapter 1: How to Get Started in Pediatric CDI

• Engaging Administration
• Building a CDI Program
• Program Rollout

Chapter 2: Coding and Payment System Overview

• The International Classification of Diseases (ICD) Code Set
• Considerations Affecting Code Assignment
• Principal and Secondary Diagnosis Selection
• MS-DRGs
• APR-DRGs
• APR-DRG and the Pediatric CDI Professional

Chapter 3: Pediatric Clinical Considerations

• Congenital Cardiac Conditions
• Developmental Diagnoses
• Encephalopathy
• Nutritional Conditions
• Gastroenterological Conditions
• Respiratory Conditions
• Sepsis

Chapter 4: Pediatric Physician Support

• Hospital and Physician Compare Websites
• Building CDI and Physician Relationships
• Providing Resources and Education for Pediatric Physicians

Chapter 5: Metrics and Analysis

• Productivity Standards for the CDI Specialist
• Return on Investment Trends
• Auditing CDI-Initiated Queries

Appendices

• Appendix A—Sample Queries
• Appendix B—White Paper: Developing Pediatric Respiratory Failure Definitions
• Appendix C—U.S. News & World Report Best Children’s Hospitals Measures