CDI Services to Uptick in Advance of ICD-10 Transition

Clinical Documentation Improvement (CDI) services and initiatives will triple as more hospitals shift to the ICD-10 code-set in advance of the Oct. 1, 2015 deadline, according to new research.

Of the 550 hospital technology and physician leaders surveyed for the research, from the New York-based Black Book Market Research, 24 percent outsource clinical documentation audit, review, and programming services. Seventy-one percent of respondents plan on having a CDI services help them adjust and survive under the new codes.

“There is no greater opportunity on the providers’ horizon to maximize financial viability than to improve the accuracy of provider clinical documentation,” Doug Brown, managing partner of Black Book, said in a statement.

Of the 200+ bed hospital category, 88 percent who have outsourced CDI say they have realized significant (over $1M) gains in appropriate revenue and proper reimbursements. Eighty-three percent say they have received quality improvements and increases in the case mix index. Twenty-eight percentage of hospitals presently outsourcing coding and CDI are contemplating a switch to second generation CDI vendors as physician practice acquisitions and EHR implementations have threatened the sustainability or effectiveness of their current CDI programming.

“Transitioning to ICD-10 is a complicated process and hospitals are leaning on the expertise and successes of outsourcing vendors,” said Brown. “We still operate in an ICD-9 world, complicated  by EHR implementations, value-based reimbursement models, compliance issues and optimizing reimbursement; a perfect storm from which outsourcers have the expertise to shield their clients.’

A recent webinar, hosted by the Weymouth, Mass.-based consulting firm, Beacon Partners, noted that creating a CDI program was one strategy to capitalize on the ICD-10 delay.