Tip: Teach physicians 'The three P's'
CDI Strategies, October 4, 2007
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To help physicians understand the ramifications of documenting for severity under Medicare Severity DRGs (MS-DRGs), William Haik, MD, director of DRG Review, Inc., in Ft. Walton Beach, FL, encourages clinical documentation improvement specialists to incorporate the "three P's" in their educational sessions. These include the following:
- Profile: Physician profiling is based on ICD-9-CM coding
- Payment: Physicians' payment schemes (RBRVS) and E/M codes are based on specificity and complexity of disease
- Patients: Physicians' patients will not receive the advanced care they deserve from the hospital-e.g., low patient to nurse ratios, fourth generation antibiotics-unless the hospital can show how severely sick the patient is. Full and accurate documentation ensures that the hospital receives the appropriate reimbursement and therefore obtain the required resources to provide optimal healthcare.
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