The CDI for Outpatient Boot Camp is the new go-to source for outpatient CDI professionals and those seeking to begin a CDI program in the outpatient arena.

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CDI for Outpatient Boot Camp

Product Code: OPBC

The CDI for Outpatient Boot Camp is the new go-to source for outpatient CDI professionals and those seeking to begin a CDI program in the outpatient arena.


Interested in this class?

Check out the Online Version or to be put on a notification list when a new date is added email us at
PD-IS@SimplifyCompliance.com

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 new go-to source for outpatient CDI professionals and those seeking to begin a CDI program in the outpatient arena.

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

CDI for Outpatient Boot Camp provides tools for outpatient CDI professionals to practice in the outpatient setting and understand the impact of CDI functions. While outpatient CDI is still in it’s infancy, ACDIS is taking the lead in defining roles, focus, and establishing standards and core competencies, which are covered in this course. The boot camp examines diagnoses impacting hierarchical condition categories (HCCs), record review and query, medical necessity documentation, CDI role in charge capture, and ethics and compliance.

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 the important 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, COPD, chronic respiratory failure, quadriplegia, paraplegia, hemiplegia, heart failure, cardiomyopathy, angina, CKD, pressure ulcers, chronic wounds, and status codes

CDI for Outpatient Boot Camp

Learning Objectives

Leave the CDI for Outpatient Boot Camp with a complete understanding of:

  • Outpatient CDI guidelines
  • How to conduct record reviews
  • How to query in the outpatient setting
  • Risk adjustment and Risk Adjustment Documentation Validation Audits (RADV)
  • Common conditions and diagnose important in the outpatient CDI arena
  • How to engage and educate providers on CDI in the outpatient setting

CDI for Outpatient Boot Camp

Agenda

The premier outpatient education from the most trusted name in CDI.

The CDI for Outpatient Boot Camp is the new go‐to source for outpatient CDI professionals and those seeking to begin a CDI program in the outpatient arena.

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

CDI for Outpatient Boot Camp provides tools for outpatient CDI professionals to practice in the outpatient setting and understand the impact of CDI functions. While outpatient CDI is still in it’s infancy, ACDIS is taking the lead in defining roles, focus, and establishing standards and core competencies, which are covered in this course. The boot camp examines diagnoses impacting hierarchical condition categories (HCCs), record review and query, medical necessity documentation, CDI role in charge capture, and ethics and compliance.

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 the important 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, COPD, chronic respiratory failure, quadriplegia, paraplegia, hemiplegia, heart failure, cardiomyopathy, angina, CKD, pressure ulcers, chronic wounds, and status codes

This three‐day bootcamp offers tools to better understand the many potential activities and impact that can be received from CDI functions.

DAY 1 (Total Instruction time 8 hours)

Module 1: Introduction to Outpatient CDI: The Basics (120 minutes)

This module discusses the evolution of CDI from the inpatient to the outpatient setting. The roles of CDI and Coding professionals are reviewed as related to medical record review and provider education. The module also reviews the ICD‐10‐CM and HCPCS/CPT code sets.

Learning Objectives:

  • Discuss the role of documentation within the health record
  • Discuss the evolving 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
  • Discuss the approved code sets of ICD‐10‐CM and HCPCS/CPT 

Module 2: The Official Guidelines for Coding & Reporting (150 minutes)

This module reviews the Official Guidelines for Coding and Reporting for ICD‐10‐CM diagnosis reporting with a focus on Section IV: The Diagnostic and Coding Guidelines for Outpatient Services. The module reviews how basic code assignment is performed, coding convention, 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,
  • Explain the role of AHA Coding Clinic® in code assignment
  • Define and apply the principles of first listed diagnosis selection
  • Apply Section IV: Diagnostic Coding & Reporting Guidelines for Outpatient Services

 

Module 3: Healthcare Reimbursement (90 minutes)

This module offers a review of the different 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 & Contrast the following methodologies of healthcare reimbursement
    • Fee for Service
    • Value Based
    • Shared Risk
    • Inpatient Prospective Payment System (IPPS)
    • Outpatient Prospective Payment System (OPPS)

 

Module 4: Record Review & Compliant Query (120 minutes)

This module addresses basic core functions of CDI: record review and compliant query practice. It reviews principles of record reviews in the outpatient setting and reviews the 2019 AHIMA/ACDIS guidance related to compliant query practice.

Learning Objectives:

  • Define the role of a query in CDI/coding
  • Identify and discuss the resources available to guide when and how to query based on professional industry standards
  • Incorporate industry guidance in the construction of simple queries
  • Recognize the importance of creating policies to define the query process and discuss the basic elements that should be addressed in the policy

DAY 2 (Total Instruction Time: 8 hours)

Module 5: Risk Adjustment (120 minutes)

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

Learning Objectives:

  • Explain how risk adjustment is applied to healthcare reimbursement
  • Identify the different models used in risk adjustment
  • Discuss the process of computing the Risk Adjustment Factor (RAF) score for individuals
  • Describe the process of Risk Adjustment Data Validation (RADV) audits

Module 6: Anatomy & Physiology (210 minutes)

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, COPD, chronic respiratory failure, quadriplegia, paraplegia, hemiplegia, heart failure, cardiomyopathy, angina, CKD, pressure ulcers, chronic wounds and status codes.

Learning Objectives:

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

Module 7: Evaluation & Management: Professional Services Billing (90 minutes)

This module discusses the basic documentation requirements of evaluation and management coding as defined in the both the 1995 and 1997 Guidelines for Evaluation and Management. It also covers the upcoming changes in requirements that go into effect in 2021.

Learning Objectives:

  • Define the difference between new and established patients
  • Define the term Relative Value Units
  • Explain the documentation requirements/required components for all E/M levels
  • Discuss CDI efforts to assist with E&M levels

Module 8: Quality Reporting (60 minutes)

This module reviews quality reporting measures that impact providers in the outpatient setting to include Healthcare Effectiveness Data Information Set (HEDIS), Medicare Access & CHIP Reauthorization Act (MACRA), and Merit Based Incentive Payment System (MIPS). Alternative Payment Models incorporating risk and quality are also discussed such as Accountable Care Organizations and patient Family Centered Medical Homes.

Learning Objectives:

  • Describe the purpose of HEDIS Measures
  • Discuss the types of measures monitored within HEDIS measures
  • Describe MACRA and MIPS Reporting
  • Discuss Alternative Payment Models
  • Identify how CDI function can offer impact to the above quality measures

 

DAY 3 (Total Instruction Time: 5 hours)

Module 9: CDI Function in Charge Capture (60 minutes)

This module discusses the function of CDI in the outpatient setting related to charge capture. We discuss activities related to denials management, medical necessity of care such as work related to National and Local Coverage Determinations. Charge capture related to observation charges, injections/infusions and chargemaster are discussed.

Learning Objectives:

  • Discuss the role of CDI in denials management
  • Define the purpose of NCD/LCDs and how they can be used to promote supportive documentation
  • Discuss reimbursement related to observation status and how CDI can assist with accurate capture
  • Define the term Chargemaster and functions to manage charge practices

Module 10: Physician Engagement & Education (90 minutes)

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

Learning Objectives:

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

Module 11: CDI Metrics, Ethics & Compliance (60 minutes)

This module discusses common metrics used to measure and communicate the impact of CDI efforts. We review efforts to minimize vulnerability and to understand the functions government audit agencies, office of the Inspector General and the False Claims Act. The ACDIS Code of Ethics is reviewed.

Learning Objectives:

  • Discuss common metrics used to measure CDI impact
  • Review the ACDIS Code of Ethics
  • Describe the function and focus of the following audit initiatives
    • Comprehensive Error Rate Testing
    • Recovery Auditors
    • Program Safeguard Contractors and Zone Program Integrity Contractor
    • Office of Inspector General
    • Medicare Administrative Contractor
    • Commercial Audit
    • Risk Adjustment Data Validation

 

Wrap up and Question/Answer/Discussion (30 minutes)

Module 12: CCDS‐O Exam Preparation (not included in instruction time: 30 minutes)

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

CDI for Outpatient Boot Camp

Continuing Education

Association of Clinical Documentation Integrity Specialists (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).

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.

American Health Information Management Association (AHIMA)
This program has been approved for 21 CE credits for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

American Nurses Credentialing Center (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.

California Board of Registered Nursing
HCPro is approved by the California Board of Registered Nursing to provide 25 nursing contact hours. California BRN Provider #CEP 14494.