Financial impact of accurate discharge coding in a liaison psychiatry service

Jordan, Iain; Barry, Helen; Clancy, Maurice; O'Toole, Desmond; MacHale, Siobhan

doi:10.1016/j.jpsychores.2012.09.017

Cited by 7 publications

(7 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has long been recognised that patients referred to CL services are a complex and expensive cohort, and that psychiatric comorbidities are poorly documented, leading to inadequate coding. 19,20 In one recent study, the administrative coding for psychiatric diagnosis accurately matched the psychiatrist’s coding in only 35% of cases. 20 It has been demonstrated that improving the accuracy of discharge coding with psychiatric comorbidity can move a patient into a higher DRG, which may be more appropriate given the recognised associations with longer lengths of stay, poorer outcomes and higher costs compared with inpatients without psychopathology.…”

Section: Additional Challenges Of Activity-based Funding For Mental Hmentioning

confidence: 99%

“…20 It has been demonstrated that improving the accuracy of discharge coding with psychiatric comorbidity can move a patient into a higher DRG, which may be more appropriate given the recognised associations with longer lengths of stay, poorer outcomes and higher costs compared with inpatients without psychopathology. 19 ABF may provide an impetus to address this problem.…”

Section: Additional Challenges Of Activity-based Funding For Mental Hmentioning

confidence: 99%

See 1 more Smart Citation

Activity-based funding: implications for mental health services and consultation-liaison psychiatry

Wand

2014

Australas Psychiatry

View full text Add to dashboard Cite

Activity-based funding may provide an opportunity for mental health services to be more equitably resourced, but much needs to be done to demonstrate that the funding model works in mental health. It is important to ensure that data collected is meaningful and accurate and reflects the diverse roles of mental health clinicians, including in CL. Inpatient and community services should be integrated in the model, as well as safeguards against potential abuse. Clinicians, in partnership with initiatives such as the Australian Mental Health Outcomes and Classification Network, are best placed to guide the development of an ABF system for mental health which appropriately recognises the complexity and variability between patients in different settings.

show abstract

Section: Additional Challenges Of Activity-based Funding For Mental Hmentioning

confidence: 99%

Section: Additional Challenges Of Activity-based Funding For Mental Hmentioning

confidence: 99%

Activity-based funding: implications for mental health services and consultation-liaison psychiatry

Wand

2014

Australas Psychiatry

View full text Add to dashboard Cite

show abstract

“…Multiple studies have demonstrated that the complexity of hospitalized patients may not be accurately characterized in discharge documentation coding, and that this inaccuracy may be associated with a loss of reimbursement to the hospital. 1 , 2 The documentation of additional diagnoses on discharge or other medical comorbidities may also be lacking. 3 A number of quality improvement initiatives have been developed to address and improve inaccurate discharge documentation, including direct feedback mechanisms, 4 - 6 the use of discharge summary templates and evaluation instruments, 7 - 9 and educational curricula.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Neurology Inpatient Documentation: A Pilot Study of a Novel Discharge Documentation EHR Tool

Kerbel

O’Brien

et al. 2023

The Neurohospitalist

View full text Add to dashboard Cite

Background and Purpose Clinical documentation of patient acuity is a major determinant of payer reimbursement. This project aimed to improve case mix index (CMI) by incorporating a novel electronic health record (EHR) discharge documentation tool into the inpatient general neurology service at the University of California, Los Angeles (UCLA) Medical Center. Methods We used data from Vizient AMC Hospital: Risk Model Summary for Clinical Data Base (CBD) 2017 to create a discharge diagnosis documentation tool consisting of dropdown menus to better capture relevant secondary diagnoses and comorbidities. After implementation of this tool, we compared pre- (July 2017-June 2019) and post-intervention (July 2019-June 2021) time periods on mean expected length of stay (LOS) and mean CMI with two sample T-tests and the percentage of encounters classified as having Major Complications/Comorbidities (MCC), with Complication/Comorbidity (CC), and without CC/MCC with tests of proportions. Results Mean CMI increased significantly from 1.2 pre-intervention to 1.4 post-intervention implementation ( P < .01). There was a pattern of increased MCC percentages for “Bacterial infections,” “Other Disorders of Nervous System”, “Multiple Sclerosis,” and “Nervous System Neoplasms” diagnosis related groups post-intervention. Conclusions This pilot study describes the creation of an innovative EHR discharge diagnosis documentation tool in collaboration with neurology healthcare providers, the clinical documentation improvement team, and neuro-informaticists. This novel discharge diagnosis documentation tool demonstrates promise in increasing CMI, shifting diagnosis related groups to a greater proportion of those with MCC, and improving the quality of clinical documentation.

show abstract

“…Il n'existe que très peu d'études concernant la valeur ajoutée économique apportée par une équipe de psychiatrie de liaison à la valorisation des diagnostics et des séjours en services de médecine ou de chirurgie ou d'obstétrique l'ayant sollicitée [1][2][3][4]. Cependant, la présence d'une comorbidité « psychiatrique » ajoutée aux pathologies « somatiques » est estimée, pour la prévalence, aux environs de 30 % [5][6][7].…”

Section: Introductionunclassified