Greater Specificity in Pediatric Clinical Documentation

When it comes to clinical documentation, it is important for pediatric healthcare organizations to have clear communication. Along with communication, specificity is key. Preventing things from getting lost in translation can mean increased quality scores. Patients, physicians, and coders all benefit from an increased level of detail. So how do pediatric hospitals gain greater detail and specificity in coding? By seeking out the consultation of skilled pediatric CDI professionals.

Implementing a clinical documentation improvement program in your hospital has numerous benefits. Case mix index can be increased, as well as compliance, and revenue. The scope of these benefits are not limited here, and hospitals will continue to benefit for years to come from  the education provided by CDI specialists. With more issues on the horizon, there is no better time than now to begin your program.

DCBA, a clinical documentation improvement company, helps children’s hospitals and other pediatric health care organizations to advance their current documentation, and help bring about the clearest communication between staff. With years of experience helping pediatric hospitals, as well as adult acute care hospitals, DCBA brings excellence in the field of clinical documentation improvement.

ICD-10 Training for Pediatric Hospitals

ICD-10 training is becoming more and more relevant for pediatric hospitals. This change will create some new documentation challenges for coders and clinical documentation specialists. With the new standards differing from ICD-9, an increased number of codes will allow for more specificity. This could mean that those who were proficient in ICD-9 could have difficulty working through the new guidelines. Healthcare providers who have not yet put in place a strategy to prepare for the changes must realize that the clock is ticking.

In addition to the new challenges with ICD-10, clinical documentation improvement programs can help children’s healthcare organizations increase case mix index, billing accuracy, and hospital profiles. Documentation directly supports coding which can affect hospital reimbursement and revenue. Starting a CDI program could be a key survival strategy for pediatric hospitals. Education is an essential first step towards finding solutions in pediatric clinical documentation improvement.

DCBA helps pediatric healthcare organizations with on site education as well as electronic resources to get ready for ICD-10. They can also analyze processes and put strategies into place that help create quality documentation results. Keeping staff on the same page is important so giving the proper tools to physicians, nurses, and billing and coding specialist provide a cohesive effort toward more accurate documentation. Children are not adults, and thats why DCBA has created CDI programs specifically for children’s healthcare.

Pediatric Clinical Documentation in ICD-10

Many who consult with physicians and healthcare organizations treat pediatric concepts the same as they would adult acute care. They feel that the same principles apply across the board. This could not be farther from the truth. Children are not adults. Their illnesses and conditions vary from those in the adult and geriatric age groups. Children’s cardiologists are not going spend much time becoming educated on ischemic heart disease. Pediatric healthcare organizations need solutions to issues that they face in their sector.

ICD-10 will mean greater specificity for documentation and coding staff. Those who are proficient in ICD-9 may have difficulties with ICD-10 without necessary preparation. For instance, diabetes as a condition has expanded to over 200 codes, a significant leap from the 60 something codes prior. But, because our practices have changed greatly since ICD-9 was implemented in the late 70’s, the need for a new system is upon us.

Greater attention to detail is key with coding. Communication is vital for success.With the experience of helping hundreds of organizations and a skilled consulting team of doctors, nurses, and coders, DCBA brings it’s experts in to address the issues that children’s hospitals deal with. By working directly with hospital staff and providing on site education as well as online resources DCBA delivers strategies that are specific to each organization. With the help of CDi Trax software, documentation specialists can streamline their processes and better manage their workflow. DCBA strives to provide solutions and results with the highest level of service in the industry.

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ICD-10 To Bring More Codes, Detail

Most healthcare providers are bracing for ICD-10’s implementation. Many organizations have taken steps to prepare for the coming shift, but there are still groups who need assistance. Two keys for preparation are to gain ICD-10 training for employees and seeking out a clinical documentation improvement program to strengthen understanding and gain consistency.

ICD-10 will mean greater specificity for documentation and coding staff. Those who are proficient in ICD-9 may have difficulties with ICD-10 without necessary preparation. For instance, diabetes as a condition has expanded to over 200 codes, a significant leap from the 60 something codes prior. But, because our practices have changed greatly since ICD-9 was implemented in the late 70’s, the need for a new system is upon us (some would say overdue.)

The greater specificity of ICD-10 isn’t frightening, it is essential and will be much better for health care in the long run. DCBA, a clinical documentation improvement company, has been helping clients all over the country prepare for the coming changes that ICD-10 will bring. By working directly with staff with industry professionals, they provide comprehensive solutions to get pediatric hospitals prepared. Documentation improvement programs hold many advantages that can lead to increased compliance, productivity, and revenue.

CDI Question: Neutropenic Fever in AML

Do you have clinical documentation improvement questions? Some documentation and coding scenarios bring about challenges which are difficult to navigate. Fortunately, you can bring your CDI questions to CDItalk, the industry leading clinical documentation improvement forum.

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