Rules of the game
• Every table is a team.
• Share the ACDIS bingo cards with each other at
your table.
• Every card at your table should be the same.
• Each table should select a team
leader/secretary to be the official ACDIS bingo
keeper.
– [CHANGE THESE RULE to FIT YOUR
NEEDS]
Rules of the game (cont.)
• The game caller, [PICK GAME LEADER], picks a
“key word” and read several “clues” related to that
“key word.” [LIST OF KEY WORDS on slide 5]
• The players must identify the correct “key word”
from the clues and mark it on their BINGO/ACDIS
Card [http://print-bingo.com/bingo-cardscustom.php to create cards] with a pencil or pen.
• When a team marks five in a row vertically,
horizontally, or diagonally the team should shout
“ACDIS!”
Rules of the game (cont.)
• Volunteers will verify your ACDIS bingo win and
provide your table with a prize to share.
• The first table to fill every square on the ACDIS
bingo card will win [PICK SMALL PRIZES].
• Game play will continue until the first team
covers its ACDIS bingo card or the time runs
out.
• Has more than 3,000 members
• Is a community in which CDI
professionals share strategies for
successful CDI programs and
achieve professional growth
• Its mission is to bring CDI
specialists together
– There are more than 40 of these in the United
States
– The newest include pediatric/NICU and
Critical Access Hospital Networks
– Have more than 1,500 collective members
• Was first administered at the 2008 ACDIS
Conference in Las Vegas
• Now has more than 1,000 individuals with the
designation
• Is offered at 170 remote testing sites
• Florida has the most certified individuals
• Where ACDIS members share sample query
templates, physician education materials, and
policies and procedures
• Contains more than a 100 sample documents
ACDIS members can adapt for their facility’s
use
• Where PowerPoint presentations from every
ACDIS conference are stored
• Is known as a center of the music industry
• Is the capitol of Tennessee
• Is the location of the 2013 ACDIS National
Conference
• Is home of the Grand Ole Opry
• A tasty treat enjoyed as a child; often with a
grilled cheese sandwich
• A television show that aired on E! that showed
funny clips of the previous day’s talk shows
• Colloquial term for the collection of government
auditors and CMS payment reporting agencies
including, CERT (Comprehensive Error Rate
Testing), ZPIC (Zone Program Integrity
Contractors), MIC (Medicare Integrity
Contractors), Recovery Auditors
• Divided into four regions: A, B, C and D
• Perform post-payment and now, pre-payment
reviews
• Used to be called Recovery Auditors (formerly
Recovery Audit Contractors [RACs])
• Not something you buy at McDonalds
• Everyone who has Medicare patients
has one of these
• Medicare Administrative Contractors
• The opposite of salt
• Not a vegetable
• AKA: Program for Evaluating
Payment Patterns Electronic
Report
• CMS will not reimburse for care associated with
these conditions
• Took affect under the Deficit Reduction Act of
2006
• Hospital Acquired Conditions
• Endorsed by 43rd World Health Assembly in
1990.
• The topic of a new two-day CDI Boot Camp
• A medical classification list for coding of
diseases, signs and symptoms, abnormal fin
• Dings, complaints, social circumstances and
external causes of injuries or diseases as
mandated by WHO
• Commonly used indicators for intensity of
hospital resource utilization.
• The average diagnosis related group weight of
all hospitals’ Medicare volume.
• Under PPS, rather than costs, it is the most
important factor in payment variations per case
across hospitals.
• Presenting a question or seeking clarification to a
physician regarding incomplete, conflicting,
contrasting, nonspecific or the lack of clinical
documentation
• A communication tool used by coders and nurses
who perform concurrent and retrospective review
of the medical record to assign the most accurate
ICD-9 code
• Can be used as a physician/provider educational
tool
• Allows for verbal queries to
occur while patient treatment is
on-going
• Medical record review of
inpatient admissions to identify
incomplete, nonspecific,
conflicting or contrasting
documentation when there is
no documentation, but clinical
indications otherwise
• It’s what we do
• Leverage to elicit
physician/provider cooperation
when publicly reported
• Can be used as a performance
evaluation tool for CDS
• Is often reported to
administration and monitored by
the physician advisor
• What most CDI programs dream their physician
query response rates could be
• What most CFOs wish the CDI chart review
rate for all payers could be
• What the review rate for mortalities should be.
• According to AHIMA, these may be used as long
as all clinically reasonable choices are listed,
regardless of the impact on reimbursement or
quality reporting
• Choices should include an “other” option, with a
line that allows the provider to add free text
• Should include option of “unable to determine”
• Should be designed to be as open ended as
possible
• Is present in 55%–85% of patient cases
• Query for related conditions such as obesity and
cachexia
• Work with dieticians to develop clinical
indicators
• Inflammation of the lungs and airways to the
lungs (bronchial tubes) from breathing in foreign
material (incl. fluid).
• Query for specificity when physician writes
“possible aspiration”.
• Infiltrate most likely to be seen in right upper
lobe.
• The term used to describe inadequate gas
exchange by the respiratory system
• MS-DRG 189
• Typically develops with conditions such as
COPD, pneumonia, severe heart failure, AIDS
• Cannot be used interchangeably with
“respiratory insufficiency”
• Definitely do not document
urosepsis
• A clinical syndrome that
complicates severe infection
• Represents the systemic response
to an infection
• Characterized by systemic
inflammation and widespread
tissue injury
• Echocardiogram shows an ejection fraction (EF)
of less than 40%, indicative of systolic heart
failure, or an EF of greater than 50%, generally
indicative of diastolic heart failure
• Look for evidence of decreasing EF and usage
of home heart failure medications
• Look for documentation of increasing doses of
diuretics (e.g., physician order of “Lasix 40 IVP
now” or “Increase Lasix to BID”). These orders
may indicate treatment of an acute or acute-onchronic episode of heart failure.
• May be caused by advanced and severe
disease states, by infections, or
medications
• Main causes include: liver disease, kidney
disease, and lack of oxygen to the brain
due to infection
• CDI specialists need to query for
underlying infection
• One common symptom can be
pain upon deep respiration.
• Can be in the form of air, fat or
blood-formed.
• Confirmed by positive lung scan
• Sudden loss of kidneys ability to perform their
main functions of eliminating excess electrolytes
as well as waste materials from blood.
• The goal of treatment is to restore kidney
function and prevent fluid and wastes from
building in the body.
• Kidney or abdominal U/S is the preferred test for
diagnosing this condition.