The Wilshire Group Blog

Outpatient CDI Readiness

Written by Mark LeBlanc | May 18, 2015 3:00:52 PM

The talk of Outpatient CDI has been going on since the fall of 2014 as we began to understand more about the impact of ICD-10 on the outpatient environment. Although the CPT codes will not be changing, the need to capture the correct ICD-10 code for the diagnosis warranting the outpatient encounter is key. ICD-10 PCS will be the most challenging for this arena as it will require more specificity than currently needed for ICD-9 (in many cases). Although Inpatient vs. Outpatient CDI is very different, there are some similarities and thus organizations should be looking at how they will give the support needed to the outpatient areas around ICD-10 readiness. So much of these areas are routine and have pre-set orders, pre-set charge sheets, and (since usually a Global payment) minimal documentation, especially around chronic conditions impacting the encounter. I think that the increase of CDI involvement in the Outpatient arena will be forthcoming.