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ACDIS Symposium Outpatient CDI Conference (BLR)

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Austin, TX 78704

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ACDIS Symposium: Outpatient CDI Conference


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November 14-15, 2019 | Hyatt Regency Austin

The ACDIS Symposium: Outpatient CDI Conference features two days of education and networking dedicated to clinical documentation improvement (CDI) in the outpatient setting. Join us for this one-of-a-kind conference featuring two concurrent educational tracks of diverse sessions, including how to get started in the ambulatory setting, query techniques and nuances, metrics and analytics, staff training, and demonstrating return on investment.

Learn from your peers and the nation’s foremost outpatient CDI experts while you take advantage of a unique networking experience.


Topics include sessions on:

  • Building an outpatient CDI program

  • Risk adjustment: Common diagnoses often missed in outpatient documentation

  • Outpatient query practices: Building compliant queries

  • MACRA and MIPS: A look at physician quality and payments

  • Critical differences between inpatient vs. outpatient coding guidelines

  • How to teach physicians E/M—medical school did not

  • From inpatient to outpatient: Defining the different documentation, coding, and reimbursement requirements


Also included is a special “lightning round” ideas-sharing session and a dedicated Q&A panel to help answer your most pressing questions.


Who should attend?

  • Clinical documentation improvement (CDI) specialists

  • CDI managers/directors

  • Coding compliance directors/managers

  • Coding compliance specialists

  • Outpatient coders

  • Case management directors/ managers

  • HIM directors

  • Revenue cycle directors

  • Physician champions/advisors to CDI

  • Quality improvement professionals

  • Coding managers/supervisors

  • Chief medical officers

  • Denials and appeals managers

  • Compliance officers

  • Chief financial officers

At the conclusion of the ACDIS Symposium: Outpatient CDI Conference, you will be able to:

  • Develop strategies to begin or improve outpatient CDI programs

  • Modify existing CDI programs to include review of outpatient documentation and risk-adjusted methodologies such as HCCs

  • Design CDI education for physicians related to outpatient practice

  • Incorporate CDI data to track and report program progress and drive improvements

  • Recognize compliance risks in the query process



AGENDA

ACDIS Symposium: Outpatient CDI Conference

Day 1— Thursday, November 14, 2019

7:00 A.M.—8:00 A.M.

Registration and continental breakfast – Exhibit Hall (60 mins)


8:00 A.M.—8:15 A.M.

Introduction and welcome remarks


8:15 A.M.—9:15 A.M.

General Session (keynote)


9:30 A.M.—10:30 A.M.

Breakout Sessions


Track 1: Richard Pinson, MD, FACP, CCS, presents “A Deep Dive into HCCs.” (B/I) What are Hierarchal Condition Categories (HCCs)? Why are HCCs important? During this session, attendees will acquire pertinent knowledge to identify, query, and capture HCC diagnoses completely and compliantly. They will learn the effect of HCCs on revenue and performance metrics and be able to explain and calculate risk-adjustment factor scores.

Track 2: Andrea J. Eastwood, RHIA, BAS, and Julia (Judy) Moreau, RN, MBA, present “Implementing Outpatient CDI in the Acute Care Hospital.” (I) Implementing an outpatient CDI program can be daunting but during this session, the speakers will explain how to phase in outpatient efforts and demonstrate the progress being made throughout this system’s 46 acute care CDI programs.

10:30 A.M.—11:00 A.M.

Networking break (30 mins) – Exhibit Hall


11:00 A.M.—12:00 P.M.

Breakout Sessions


Track 1: Deanne Wilk, BSN, RN, CCDS, CCS, presents “How to Handle the Problematic Problem List.” This presentation will provide background and history of the problem list, who developed, initial intent, and who should and could make entries on the problem list. It will discuss regulatory standards and requirements in relation to the problem list. There will also be discussion of how to handle the problem list, improve documentation within the problem list and the effect this has on the quality and financial picture of the organization. There will be blackbelt project and case study material shared.

Track 2: Jennifer Boles, CPC, CRC, and present “Joining Forces: How Ambulatory CDI can Collaborate with Inpatient CDI Staff.” (A) Baptist Health in Kentucky/Indiana invites you to learn how they have combined ambulatory and in-patient CDI specialists to share education throughout their system to meet the common goal of providing the same consistent educational message to providers, department leaders, and CDI specialists.

12:00 P.M.—1:00 P.M.

Lunch in the Exhibit Hall (60 mins)


1:00 P.M.—2:00 P.M.

Breakout Sessions


Track 1: Laurie L. Prescott, RN, MSN, CCDS, CDIP, CRC, and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS, present “Eeeny-Meeny-Miney-Mo: Picking the First One is a NO! The Pitfalls of Provider Self Coding.” (I) Many providers self-code their records in the outpatient setting as a way to decrease costs. The majority of providers, however, are not proficient in code assignment and perform this function by choosing codes found in a dropdown menu with little to no consideration if their documentation actually supports their choices. This presentation will explore common pitfalls related to physician self-coding, strategies to identify these concerns, and tools to empower both CDI professionals and providers.

Track 2: Ashley Chamberland, BSN, RN, CPN, and Terriann DeLucia, BSN, RN, present “Educating and Obtaining Buy-in From Your Providers in the Primary Care Setting.” (B) During this session, attendees will learn how an established two-year-old ambulatory CDI program in primary care practices operates including best practices for educating providers on what CDI is and how to improve information sharing and decrease queries while increasing documentation quality and safeguarding revenue integrity.

2:00 P.M.—2:30 P.M.

Networking break (30 mins) – Exhibit Hall


2:30 P.M.—3:30 P.M.

Breakout Sessions


Track 1: Sharme Brodie, RN, CCDS, presents “Clinically Speaking: Conditions Treated in the Outpatient Setting.” (I) Many CDI professionals are more familiar with the conditions treated in the acute care setting but need a refresher regarding the chronic conditions diagnosed and monitored outside the inpatient admission. This session will explore chronic conditions related to endocrine, renal, respiratory, and digestive systems, discussing what presenting signs and symptoms CDI professionals should look for and how to effectively query to obtain codeable language in the medical record.

Track 2: Cassie L. Birnbaum, MS, RHIA, CPHQ, FAHIMA, presents “Leading the Way with Ambulatory Single Path Documentation Excellence.” (A) The effect of clinical documentation and coding has expanded as CMS and other payers shift from fee-for-service to value-based payment models. Listen to physician office CDI strategies from the field to learn how to support value-based payment models AND risk adjustment.

3:40 P.M.—4:40 P.M.

Lightning Round Panel Session


4:40 P.M.

Adjourn


4:40 P.M.—5:40 P.M.

Reception in the Exhibit Hall (60 mins)




Day 2— Friday, November 15, 2019

7:00 A.M.—8:00 A.M.

Continental breakfast – Exhibit Hall (60 mins)


8:00 A.M.—9:00 A.M.

General Session


9:10 A.M.—10:10 A.M.

Breakout Sessions


Track 1: Karen Newhouser, RN, BSN, CCM, CCDS, CCS, CDIP, presents “Let’s talk about Evaluation and Management: What do we need to know?” (B) A firm understanding of evaluation & management (E/M) code assignment factors will help ensure not only physician support for CDI efforts on the inpatient side but also medical record and reimbursement accuracy on the outpatient side. This session outlines the essentials of the E/M coding system and provides analysis and insight into what aspects of CDI efforts work best to engage physicians and improve outcomes related to the complexities of E/M.

Track 2: Jessica Vaughn, MSN, RN, CCDS, CRC, and Barbara Lennon, MD, CDIP, CRC, present “Hitting the Target: Leveraging Data to Optimize CDI and Find Success in Value-Based Healthcare.” (A) The outpatient CDI program at Wake Forest Baptist Health in Winston-Salem, NC, partners with CHESS, a value-based healthcare enablement company, assisting in data analysis and strategic multidisciplinary partnerships providing a unique approach for CDI to target physician education and support. During the presentation, attendees will gain insight into the development of strategically integrated processes leveraging near real-time clinical data along with claims data, to secure a targeted focus in meeting value-based healthcare objectives and organizational goals.

10:10 A.M.—10:40 A.M.

Networking break and dedicated poster viewing time – Exhibit Hall (30 mins)


10:40 A.M.—11:10 A.M.

Sponsored Session


11:25 A.M.—12:25 P.M.

Breakout Sessions


Track 1: James W. Manz, MD, presents “Clinical Considerations for Effective Outpatient and Ambulatory Efforts.” (A)

Track 2: Laurie Benz, CCS, CPC, and Christine Poleon present “Don’t Let Data Become a Monkey Wrench to your Outpatient CDI Efforts.” (I) With the amount of data growing every day, it can be hard to know what to do with it or how to get your priorities organized, but data dumps needn’t throw a wrench in your CDI program’s workflow. This session will provide insight on how to easily analyze commercial and Medicare data to benefit outpatient CDI. Participants will learn formulas for government and commercial payers which will streamline data analysis in real time, view how data is used to create a case to implement outpatient CDI, and work through case scenarios related to HCCs, E/M, and denials prevention.

12:25 P.M.—1:25 P.M.

Lunch provided – Exhibit Hall (60 mins)


1:25 P.M.—2:25 P.M.

Breakout Sessions


Track 1: Sonia Trepina, MPA, and Brett Senor, MD, CRC, CCDS, present “Risk Adjustment Methodology 101: How to Make Sense of it All.” (I) New to the world of risk adjustment methodologies? Would you like to understand the history, the current state and future outlook for risk adjustment reimbursement? Whether you are new to risk adjustment or want to prepare for 2020, this session is for you.

Track 2: Bobbie Starkey, RHIT, CCS-P, “Capture CDI Accuracy to Drive Quality and Revenue in the Emergency Department.” (B) In the emergency department (ED), charges come in from various ancillary departments: radiology, labs, respiratory therapy, cardiology, etc. CDI specialists, coders, and quality professionals should understand how the charges work, including drug administration code assignment and overall ED reimbursement policies. Take a fresh look at the ED revenue cycle during this session with specific insights into common diagnosis and procedure errors. Attendees will review several ED code assignment case studies to understand why success depends on a team effort between CDI, coding, and quality. Learn how documentation specialists can drive best practices in the ED to promote quality outcomes, reduce denials, and ensure CDI accuracy.

2:30 P.M.—3:15 P.M.

Panel Session: ACDIS Advisory Board Hot Topics and Q&A


3:15 P.M.

Adjourn




SPEAKERS

ACDIS Advisory Board

Task: Providing leadership, expertise, and an industry voice for the ACDIS membership. Click here to download the committee scope of work. To vote in the 2019 ACDIS Advisory Board elections, click here. Please note that you must be an ACDIS member to vote.

To view ACDIS Advisory Board frequently asked questions, please click here.

Sheri Blanchard, RN, MSN, FNP-BC, CCDS, CCS
Corporate director of CDI
Orlando Health
Orlando, Florida
sheri.1986blanchard@gmail.com

Blanchard has more than 24 years of nursing experience, and 12 years of CDI, care management, and coding experience, with a focus on improving patient care, quality outcomes, and the financial stability of hospital systems nationwide.

Blanchard is a subject matter expert on assessing hospitals for areas of opportunities and implementing change through collaboration and DRG bill-hold reviews. She has developed reports to track mortality review opportunities, Emergency Care Research Institute measures, patient safety indicator (PSI) and hospital acquired condition reviews, individual CDI metric reports, implementing CDI in the ED with care management, and denial intervention for DRG validations. She works in collaboration with her CDI team, key departments, and providers to develop diagnosis definitions to align with evidence-based practice. Blanchard is a past co-leader for the Central Ohio ACDIS.

Elected to the board in 2019; serving through April 2022

Tracy Boldt, RN, BSN, CCDS, CDIP
Manager, clinical documentation integrity
Essentia Health
Duluth, Minnesota
tracy.boldt@essentiahealth.org

Boldt was drawn to the CDI professional because it fit perfectly with her passion for ensuring the best patient care, showing great outcomes, accurately portraying the patient’s clinical picture, and educating physicians that all of this is possible through improved documentation. Boldt had the opportunity to start a CDI program while working as a CDI specialist. From there, she became an ICD-10 educator for a large multi-specialty hospital, and then began nationwide CDI consulting and education for several years. Currently, she works as a system manager for a large multi-specialty healthcare system.

During her 11-year career in the CDI field, she has participated on many local and national ACDIS committees and co-chaired the Minnesota ACDIS local chapter from 2012-2015. Boldt has spoken at the ACDIS national conference, the ACDIS Symposium: Outpatient CDI, local AHIMA conferences, on Talk Ten Tuesday, and ACDIS Radio. She implemented a new outpatient CDI program at her current healthcare system, co-authored The Outpatient CDI Specialist’s Completed Training Guide and volunteered on the CCDS-O committee. She has been in the nursing field for 15 years.

Elected to the board in 2019; serving through April 2022


Angie Curry, RN, BSN, CCDS
Senior consultant, Client services manager
Nuance Healthcare
Nixa, Missouri
angie.curry@nuance.com

Curry is a registered nurse with 20 years of experience and a clinical background that includes cardiac care and nursing education. Moving to CDI program management in 2013, Curry found her passion as well as her professional community with ACDIS. Her next step was to become a CDI director not long after. In her current role, Curry assists clients in meeting their desired outcomes. She works closely with coding, quality, administration, and physicians to improve the accuracy of documentation, understand coding regulations, and denials trends.

She is actively involved in ACDIS events at both the national and state level and enjoys contributing to industry publications, speaking on CDI topics, and collaborating with other professional organizations.

Elected to the board in 2017; serving through April 2020


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Katy Good, RN, MSN, MHA, CCS, CCDS
Manager, Education Services
Enjoin CDI
Gallup, New Mexico
katy.good@enjoincdi.com

Good is a registered nurse with a clinical background in the ICU and ED. As the manager of education services, she is responsible for the overall development and oversight of both internal and client training materials focusing on documentation improvement across the continuum of care. She works side by side with Enjoin’s physician team to develop clinical, coding, and documentation materials based on the principals of high quality documentation, evidence based medicine and the most up to date clinical best practice guidelines, coupled with clinical coding concepts that are impactful to patient care and value-based outcomes in all settings.

In 2011, Good was tasked with expanding and systemizing a CDI program across facilities. Over the following six years, she gained extensive management and operational experience ultimately designing an operational model of success which improved the accuracy of both payment and quality outcomes while mitigating risk associated with denials. As the CDI program coordinator, she provided comprehensive education to CDI, coding, and medical staff, thorough audits of both CDI and coding, and developed processes to provide mortality, PSI, and HAC reviews.

Good has been a frequent ACDIS conference speaker and is a regular contributor to industry publications and CDI blogs. Her achievements include recipient of the 2-14 ACDIS CDI Professional Achievement Award and the Academic Achievement Award for graduating first in her nursing class in 2006. She obtained her Bachelor of Science in Nursing from New Mexico State University and is currently enrolled in the Master’s Program in Healthcare Administration from the University of New Mexico, graduating in May 2019.

Elected to the board in 2017; serving through April 2020


Fran Jurcak, MSN, RN, CCDS
Vice President of Clinical Innovation
Iodine Software
Austin, Texas
fran@iodinesoftware.com

Jurcak has been a nursing professional for more than 30 years with 12 years in the CDI profession. She currently uses her clinical knowledge and expertise to create and implement healthcare technology that supports documentation integrity. An active member of ACDIS for the past 11 years, Jurcak is past ACDIS Advisory Board member, having served from 2011-2014. She is also serving on the CCDS certification committee as well as the newly created outpatient CCDS (CCDS-O) certification committee; she is also the author of the CCDS Exam Study Guide. In 2017 Jurcak earned the ACDIS Professional Achievement Award and has spoken at multiple ACDIS national and chapter conferences and the national AHIMA conference. Jurcak is passionate about the CDI profession and works daily with CDI professionals throughout the country.

Elected to board in 2018; serving through April 2021

Vaughn Matacale, MD, CCDS
Director, clinical documentation advisor program
Vidant Health
Greenville, North Carolina
Vaughn.matacale@videnthealth.com

Matacale is a physician specializing in hospital medicine who began training and working in the physician advisor role in 2007. In 2013, he took a full-time role as a physician advisor with a mission to develop the advisor role and grow a physician advisor team for the Vidant Health system, which covers most of eastern North Carolina. Serving as the director of the advisor team, he has helped it grow to four physicians and a physician assistant who conduct post-discharge pre-bill reviews and provide support and education for coding, CDI, and medical staff throughout the health system.

Through proactive involvement and collaboration with CDI and coding, Matacale has established regular representation and collaboration with the quality, informatics and IT, evaluation and management auditing, audit and compliance, utilization review (UR), and appeals departments, and the Vidant accountable care organization. He currently serves as the chair of the PSI committee and is a member of the hospital patient safety and quality improvement committee. Matacale also has more than 13 years of experience in UR reviews and continues to practice hospital medicine. He has had the privilege of speaking at five ACDIS conferences, as well as other national and regional conferences.

Elected to the board in 2019; serving through April 2022


Chinedum Mogbo, MBBS, MsHIM, RHIA, CDIP, CCDS, CCS
Manager, CDI
Tenet Healthcare
Dallas, Texas
mogboc@gmail.com

Mogbo has a passion for quality patient care and all things CDI, including its overall impact on patient care/safety, and physician and hospital profiles. She has successfully managed various teams, including clinical documentation specialists and coding auditors. She worked as a CDI training director for a California-based health system and currently works as a CDI manager for Tenet Healthcare. She actively participates in the CDIP and RHIA exam item writing with AHIMA. She has been involved in the successful development of in-house curriculum for training clinical documentation specialists and serves as co-chair of the AHIMA CDI practice council working on many projects that provide guidance to the industry—the most recent being updating the Guidelines for Achieving a Compliant Query Practice, a joint publication between ACDIS and AHIMA..

She co-authored an AHIMA practice brief on “Physician Engagement in CDI,” featured in the July 2017 Journal of AHIMA and also co-authored the AHIMA practice brief on “Physician Office Query” in July 2018. Mogbo was a speaker at the 89th AHIMA Convention, a moderator at the 2018 AHIMA CDI Summit and presented on AHIMA webinars in 2018 and 2019.

Elected to the board in 2019; serving through April 2022


Jeff Morris, RN, BSN, CCDS
Supervisor, Clinical Documentation Improvement
University of South AL Health System
Mobile, Alabama
jwmorris@health.southalabama.edu

Morris is the supervisor of CDI at the University of South Alabama Health System in Mobile. He has more than 20 years of nursing experience in adult critical care, medical-surgical/telemetry, and emergency department. Currently, he leads the CDI program at USA Children’s and Women’s Hospital and USA Medical Center where he was the originally hired as its first CDI professional An active member of ACDIS, Morris is a co-leader for the Alabama ACDIS chapter, presented at the 2017 ACDIS Conference in Las Vegas, served on the 2018 ACDIS Conference Committee, contributed to the 2017 book Pediatric CDI: Building Blocks for Success, and is scheduled to present ACDIS 2018 in San Antonio. He is also a member of AHIMA and has presented at local and regional events.

Elected to board in 2018; serving through April 2021


Laurie Prescott, MSN, RN, CCDS, CDIP, CRC
CDI Education Director
HCPro/ACDIS
Middleton, Massachusetts
lprescott@acdis.org

Prescott is the Clinical Documentation Improvement (CDI) Education Director with HCPro, a division of BLR. Prescott serves as a full-time instructor for the CDI Boot Camps as well as a subject matter expert for the Association of Clinical Documentation Improvement (ACDIS). Prescott is a frequent speaker on HCPro/ACDIS webinars and is the author of the CDI Complete Training Guide.

Prescott started her nursing career in 1985 as a graduate of the University of Vermont School Of Nursing. Since that time she has worked at a variety of organizations including academic, large and small community hospitals. She has worked in a number of nursing roles including as manager in the areas of medical/surgical, ICU, PACU and endoscopy. Her experience also includes specialization as a compliance officer.

She completed her MSN with a focus in nursing education at the University of Phoenix and taught nursing as an adjunct instructor to ADN students. She continued her focus of nursing education in various roles. In 2007, Prescott left this role to develop and implement a CDI program and remained in this role until joining HCPro in August of 2013.

Serving on the board since January 2017


Erica E. Remer, MD, FACEP, CCDS
President and Founder
Erica Remer, MD, Inc.
Cleveland, Ohio
eremer@icd10md.com

An emergency physician for 25 years with expertise in documentation and the professional side of billing, Remer became the CDI physician advisor for University Hospitals Health System in Cleveland in 2012. Tasked with training 2,700 providers in ICD-10, she additionally closed hundreds of CDI queries and appealed numerous DRG clinical validation and medical necessity denials. After transitioning to independent consulting in July 2016, she authored multiple articles on CDI topics, serves as course director of a medical documentation through Case Western Reserve University, co-hosts Talk Ten Tuesdays, and has been a featured guest on ACDIS Radio. Remer has provided deep dives into clinical topics in presentations on the national, regional, and local level. She serves as the American College of Physician Advisors CDI education subcommittee chair and on its board of directors.

Elected to board in 2018; serving through April 2021


Susan Schmitz, JD, RN, CCS, CCDS, CDIP
Regional Director of Clinical Documentation Improvement
SCAL Kaiser Permanente
Pasadena, California
susanschmitz59@yahoo.com

Schmitz’s experience includes 36 years as a Registered Nurse and 19 years in the CDI field – from consulting, to managing hospital-based CDI programs, to serving as regional CDI director over 14 SCAL Kaiser Permanente medical centers. She is one of the authors of the CDI Reference app published by Elsevier and is considered one of their subject matter experts for their online CDI course. Additionally, she has been an ACDIS member since 2009, taking the second CCDS exam ever offered.

Elected to the board in 2017; serving through April 2020


Deanne Wilk, BSN, RN, CCDS, CCS
Manager of CDI
Penn State Health
Hershey, Pennsylvania
dwilk@hmc.psu.edu

Wilk’s experience spans 35 years in the healthcare field. Her primary nursing background includes Telemetry and Home Health nursing, transitioning into an education role and then CDI. From her original CDI role, she transitioned into consulting and management. Over the years, she has worked on numerous educational projects, articles, contributed as a subject matter expert to CDI and coding coursework, and spoken at numerous national and local conferences. Since 2015, she has been the co-host and founder of the Central Pennsylvania ACDIS chapter.

Elected to the board in 2017; serving through April 2020


Irina Zusman, RHIA, CCS, CCDS
Director of HIM Coding and CDI Initiatives
NYU Langone Health
New York City
izusman@gmail.com

Zusman has more than 25 years of HIM experience where she used her blend of clinical and CDI skills to advance data analytics and validate the importance of documentation and coding. Zusman designed two new programs at NYU School of Professional Studies—a diploma in coding, developed in collaboration with the senior director of HIMand a CDI diploma program in collaboration with the director of CDI. She has contributed as a subject matter expert on a variety of focus groups regarding coding concepts, Agency for Healthcare Research and Quality patient safety indicators and hospital acquired conditions, among other topics. Zusman currently serves on the CCDS certification committee. She has presented at AHIMA and ACDIS national and local conferences and several Vizient (formerly University HealthSystem Consortium) annual CDI pre-conference meetings.

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