What Coding Professionals Are Saying
About DCBA....

"Thanks so much. I just wanted you to know that I feel we had excellent training from Dr Catalano and your organization. After reading and listening to the info on ACDIS website I am very appreciative of the extensiveness of your program. I feel I am well prepared to do my job the best I can, for a rookie. I have found new excitement in my nursing career by doing documentation improvement and am grateful that Asante has the foresight to start our program. I am hoping down the road to be able to be a trainer in this field, too."

--CDI Specialist
Asante Health System
Medford, Oregon

" I am still amazed everyday at the intensity and level of cooperation with documentation from the majority of our physicians.  And I don’t take credit for it.  It is an expectation of the leadership here, the staff follow through willingly, and the rest just happens.  The physicians are pretty accessible on the floors so we are able to make frequent contact with them and educate as needed.  We even had a metabolic doc come up to us and ask how to document an unusual condition that was present on admission.  Even the pediatric surgeons, attendings!!!, answer our queries.  And we are presenting to the new docs coming on board at the end of the month.   So life here is good."

--CDI LIason Nurse
Riley Childrens' Hospital
Indianapolis, IN

"The Clinical Documentation Program offered by DCBA is by far the most progressive to prepare hospitals for all aspects of Severity Adjusted DRGs, Pay for Performance, Present on Admission, Quality Indicators and any other issues that each health system must be prepared to have a good grasp of for all the changes rapidly being integrated within the healthcare business. "

Randy Wagner, Wagner & Associates Clinical Information Consulting

Dr. Gold,

I just finished reading "Your documentation, your M&M profile". I cannot tell you how much I appreciate your understanding of the coding world with physician insight.

I have been in Medical Records (HIM) for 32 years and am currently a Coding Supervisor in a Hospital. It feels so good to have what I know as truth - validated by someone who knows what they are talking about. The example you gave of the "open" reduction and fixation really hit home with me. I've had physicians and other coders argue this with me but you stated the case correctly. Many "open" reductions are actually closed reductions with internal fixation. I have trained many coders. I never let them code strictly from the title the surgeon gives. That is only a reference point. I require that they read and code from the actual dictated note.

I know you are a busy man but I just wanted to thank you.

Susan Beever, RHIT, CCS
Clinical Coding Supervisor
Springfield, IL

Dr. Gold.  
I just had to tell you how much I enjoyed your article in this May publication regarding the severity of illness driven DRG changes.  The DRG system does not focus on coding accuracy, only on the principal diagnosis and CCs.  The rest of the codes for the admission can be inaccurate, missing or not supported, and no one places importance on how these errors affect the data base.  

When I reviewed cases for Michigan's QIO, it drove me crazy to see all the coding errors that CMS was receiving on the bills because I knew how they were using those codes for statistical purposes.  They were secondary codes that described frequent common conditions that are associated with specific illnesses, and coders would not report them because they didn't affect the DRG.  Codes like 250.00 and tobacco abuse would be missing from an AMI admission because coders were in a hurry to move on and  the payment wouldn't be affected to leave them off.  Unfortunately, the money is all that matters.  No one cares about the value of recording the 'whole patient story', except me.  If more doctors could express support for complete coding, maybe coding departments would listen.  

I'm hoping that the new DRG system will fix this data problem, but the proposed changes do not include areas where I see issues in my daly audits.  It is a step in the right direction though.  Even the RAC program is revenue driven so I do not have optimism that correct coding will be addressed through their findings.  Everyone is aware of the standards of ethical coding,  but if the money is coming in appropriately, no one pays attention to the gorilla in the room.  The collection of health information is really falling short of its potential and this is sad.

As usual, I thought the points you presented in this article were great.  You always hit the right notes!

Regards,
Darlene Fawaz, RHIT
Compliance Audit Specialist
Corporate Compliance
Royal Oak, MI