HCPro, JustCoding Inpatient - 2019 Issue 10 (March)
CDI and coding collaboration: Defining roles in retrospective reviews
March 5th, 2019
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Article Overview
This article explains how CDI programs and coding teams can approach retrospective reviews as an extension of concurrent review work. It discusses practical workflow design, communication between departments, physician engagement challenges, and ways organizations can manage post-discharge review processes without disrupting billing timelines. The piece is aimed at CDI specialists, coding professionals, HIM leaders, and physician advisors who are evaluating or refining retrospective review operations.
Why This Topic Matters
Retrospective reviews can help organizations identify missed documentation opportunities and improve collaboration between CDI and coding, but they also affect workflow, billing hold times, and physician response patterns. Understanding the operational roles involved helps teams decide how to implement or expand the process.
Article Sections
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Focus initial attempts on a subset of charts
This section discusses starting retrospective review work with a limited chart population and gradually expanding the effort. It covers how organizations may select cases based on timing, service lines, or review priorities.
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CDI-coding collaboration
This section describes how CDI and coding teams coordinate responsibilities during retrospective review workflows. It addresses communication pathways, handoffs, and coordination around post-discharge review activity.
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Physician engagement
This section covers factors that influence physician participation in retrospective reviews. It discusses workflow barriers, communication challenges, and strategies used to support response and documentation follow-up.
What You Will Learn
- How retrospective reviews fit alongside concurrent CDI review processes
- How organizations may phase in retrospective review workflows
- Ways CDI and coding teams coordinate responsibilities after discharge
- Common operational challenges that affect post-discharge query follow-up
- Factors that influence physician engagement in retrospective review programs
Who Should Read This
- CDI specialists
- Inpatient coding professionals
- HIM managers
- CDI leaders
- Physician advisors
- Revenue cycle leaders
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