SHM Converge Scientific Abstract ePoster Gallery-Integrated Cdi Physician Advisor

Pdf Summary

This report evaluated whether adding a physician advisor to a clinical documentation integrity (CDI) program improves coding accuracy and hospital revenue more effectively than CDI education alone or outside coding consultants.<br /><br />At Corewell Health, accurate coding was targeted through several interventions over time. A prior outside coding-education company produced only a short-lived rise in work relative value units (wRVU) per encounter, from 1.6 to 1.8, which returned to baseline within 3 months. A later pilot aimed at low-performing hospitalists also showed only temporary improvement, rising from 1.59 to 1.65 before being disrupted by COVID-19.<br /><br />The more successful intervention involved an internal physician advisor who reviewed CPT and CMS documentation rules, supported the CDI team, and helped educate physicians. The program included targeted education, biweekly coding tips, physician-led lectures, a hospitalist documentation algorithm, EPIC dot phrases for medication toxicity monitoring, and monthly scorecards comparing individual and group billing performance against CMS averages. Billing and revenue data were used to measure actual encounter-level coding, not just charge data.<br /><br />Results showed a sustained global improvement in wRVU/encounter from 1.75 to 1.95 within 4 months, an 11% increase that remained stable over the next 6 months. The authors estimate this could generate more than $1,000,000 in additional annual revenue for a group with 100,000 encounters per year.<br /><br />Overall, the study concluded that integrating an internal physician advisor into CDI efforts produced better and more durable improvements in documentation and billing than CDI education alone or use of external firms.

Asset Subtitle

Jeremy J. Gentile

Meta Tag

Author List Beth Makowski, Erin M. Walton, Jeremy J. Gentile, Kartik H. Patel MD

Category Research

Concept Physician-Advisor Support

Concept Clinical Documentation Integrity Program

Concept Coding Accuracy

Concept Documentation Quality

Concept Coding Performance

Distinguished Finalist

Presenter Organization Corewell Health

Presenting Author Jeremy J. Gentile

Track Value in Hospital Medicine

Keywords

clinical documentation integrity

physician advisor

coding accuracy

hospital revenue

wRVU

CDI education

billing performance

CPT documentation

CMS guidelines

healthcare reimbursement

Physician-Advisor Support

Clinical Documentation Integrity Program

Coding Accuracy

Documentation Quality

Coding Performance