Case Management

Sneak peek: CDI and case management a vital collaboration

Case Management Weekly, August 22, 2012

Case managers are tasked with multiple and often conflicting goals. They work with physicians and staff to facilitate and coordinate care, review medical necessity for inpatient stays, move patients efficiently through the continuum of care, and ensure the care given is high quality—all while advocating for the best interests of patients and families. 

These are not easy tasks. Collaborating with clinical documentation improvement (CDI) specialists can make the job a bit easier. 

CDI specialists help physicians clarify documentation of diagnoses in patient charts to appropriately reflect the severity of patients’ conditions. Documentation accuracy influences the predicted mortality rate and reimbursement for care. 

When a patient is admitted to an acute care setting, a CDI specialist reviews the chart for clear documentation of the principal diagnosis that necessitated admission. This review supports the medical necessity of the admission and provides case managers a clear picture to share with insurers. 

Editor’s note: This article is adapted from an article in the August Case Management Monthly published by HCPro.

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