CDI for Outpatient Boot Camp

CDI for Outpatient Boot Camp

Course Overview

Premier outpatient education from the most trusted name in CDI

The CDI for Outpatient Boot Camp is the new go-to source for outpatient CDI professionals and those seeking to begin a CDI program in the outpatient arena. This is the first-of-its kind boot camp from the trusted experts at HCPro and ACDIS.

This course defines the role of CDI specialists in the outpatient arena, provides comprehensive training, and applies ACDIS-endorsed best practices.

The CDI for Outpatient Boot Camp provides tools for outpatient CDI professionals to practice in the outpatient setting and understand the impact of CDI functions. While outpatient CDI is still in its infancy, ACDIS is taking the lead in defining roles, focus, and establishing standards and core competencies, which are covered in this course. The boot camp examines diagnoses impacting hierarchical condition categories (HCCs), record review and query, medical necessity documentation, CDI role in charge capture, and ethics and compliance.

CDI in the outpatient setting encompasses a variety of different focuses to include ED, observation, primary, and ambulatory care. The regulatory landscape and suggested best practices are rapidly evolving and organizations must work to maintain compliant, effective practices.

Leave the CDI for Outpatient Boot Camp with a complete understanding of:

• Official guidelines for Coding and Reporting in the outpatient setting
• How to conduct record reviews
• Compliant query practice in the outpatient setting
• Risk adjustment and Risk Adjustment Documentation Validation Audits (RADV)
• Common diagnoses of focus in the outpatient setting
• The process and focus of provider education 

The CDI for Outpatient Boot Camp will help you:

• Implement a step-by-step process for thorough medical record review based on industry guidelines for the outpatient arena
• Develop compliant verbal and written physician queries and understand how to effectively query providers in the outpatient setting
• Recognize significant conditions in the outpatient setting that are a common focus for review, such as HIV disease, neoplasms, diabetes, malnutrition, morbid obesity, substance abuse/dependence, major depressive disorder, COPD, chronic respiratory failure, quadriplegia, paraplegia, hemiplegia, heart failure, cardiomyopathy, angina, CKD, pressure ulcers, chronic wounds, and status codes

CDI for Outpatient Boot Camp—see the difference for yourself!

Check out all the benefits of this HCPro Boot Camp: 

• Expertly designed course materials: Course materials are developed by an adult education expert. The curriculum uses a “how to” approach where participants learn how to apply CDI concepts that they can then customize to their organizational needs. Content is regularly updated based on changing industry practices and participant feedback.
• Live instruction: Classes are taught by an experienced instructor who is credentialed as a CDI professional and works as an industry subject matter expert for ACDIS.
• Small class size: We limit the number of course participants in order to maintain a low participant-teacher ratio. This allows us to provide individual instruction as needed when participants find a topic particularly challenging; it also allows time for discussion.
• Well-established program: Brought to you by the Association of Clinical Documentation Improvement Specialists (ACDIS), this Boot Camp from the industry’s only dedicated CDI association provides the best-in-class education you expect.

Our boot camps are a comprehensive and effective way to strengthen your understanding of CDI. “Our goal as instructors is to offer detailed, thorough, and timely education that can be simply broken down and easily understood and applied in daily practice,” says CDI education director at HCPro, Laurie Prescott.

ACDIS members save $150 off the registration fee. Call 800-650-6787 to receive your special discount rate or sign up to become an ACDIS member today!

CCDS-O Examination Information

ACDIS offers a certification for outpatient CDI specialists, the Certified Clinical Documentation Specialist-Outpatient (CCDS-O) credential. We recommend the CCDS-O exam for individuals who complete this Boot Camp, meet the exam eligibility criteria, and desire to pursue certification. However, the course may not cover all the content areas tested on the exam. Consequently, depending on your background and experience, additional independent study and/or training may be required to pass the CCDS-O examination. To download the CCDS-O Candidate Handbook and view the prerequisites required to take the exam, or to download an application form, visit the ACDIS website at https://acdis.org/certification/ccds-o

For more detailed information about our Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

Looking to train your whole team? We can bring our expert instructors to you! Learn more here!

CDI for Outpatient Boot Camp

Agenda

Module 1: Introduction to Outpatient CDI: The Basics

This module discusses the evolution of CDI from the inpatient to the outpatient setting. The roles of CDI and Coding professionals are reviewed as related to medical record review and provider education. The module also reviews the ICD‐10‐CM and HCPCS/CPT code sets.

Learning Objectives:

• Discuss the role of documentation within the health record
• Discuss the evolving roles of CDI and coding professionals
• Distinguish what documentation can be used to report a code from those whose documentation can only be used as clinical indicators of a condition
• Discuss the approved code sets of ICD‐10‐CM and HCPCS/CPT 

Module 2: The Official Guidelines for Coding & Reporting

This module reviews the Official Guidelines for Coding and Reporting for ICD‐10‐CM diagnosis reporting with a focus on Section IV: The Diagnostic and Coding Guidelines for Outpatient Services. The module reviews how basic code assignment is performed, coding convention, and regulatory guidance such as AHA Coding Clinic.

Learning Objectives:

• Explain when the Official Guidelines for Coding and Reporting are updated and where to obtain official information,
• Explain the role of AHA Coding Clinic® in code assignment
• Define and apply the principles of first listed diagnosis selection
• Apply Section IV: Diagnostic Coding & Reporting Guidelines for Outpatient Services

Module 3: Healthcare Reimbursement

This module offers a review of the different healthcare reimbursement methodologies including fee for service, value based, and shared risk. The overview compares the Inpatient Prospective Payment System (IPPS) and the Outpatient Prospective Payment System (OPPS).

Learning Objectives:

• Compare & Contrast the following methodologies of healthcare reimbursement
• Fee for Service
• Value Based
• Shared Risk
• Inpatient Prospective Payment System (IPPS)
• Outpatient Prospective Payment System (OPPS)

Module 4: Record Review & Compliant Query

This module addresses basic core functions of CDI: record review and compliant query practice. It reviews principles of record reviews in the outpatient setting and reviews the 2019 AHIMA/ACDIS guidance related to compliant query practice.

Learning Objectives:

• Define the role of a query in CDI/coding
• Identify and discuss the resources available to guide when and how to query based on professional industry standards
• Incorporate industry guidance in the construction of simple queries
• Recognize the importance of creating policies to define the query process and discuss the basic elements that should be addressed in the policy

Module 5: Risk Adjustment

This module reviews key concepts of risk adjustment with a focus on the CMS Hierarchical Condition Categories (HCCs). Discussion includes review of demographic and diagnosis considerations, disease interactions, identification of documentation opportunities, risk score calculation, and Risk Adjustment Documentation Validation (RADV) audits.

Learning Objectives:

• Explain how risk adjustment is applied to healthcare reimbursement
• Identify the different models used in risk adjustment
• Discuss the process of computing the Risk Adjustment Factor (RAF) score for individuals
• Describe the process of Risk Adjustment Data Validation (RADV) audits

Module 6: Anatomy & Physiology

This module reviews diagnoses and conditions that are a common focus in CDI Outpatient reviews. Conditions include: HIV Disease, neoplasms, diabetes, malnutrition, morbid obesity, substance abuse/dependence, major depressive disorder, COPD, chronic respiratory failure, quadriplegia, paraplegia, hemiplegia, heart failure, cardiomyopathy, angina, CKD, pressure ulcers, chronic wounds and status codes.

Learning Objectives:

• Discuss diagnose/conditions that are a common focus in CDI outpatient reviews
• Identify opportunities for query and provider education in the outpatient setting
• Apply Coding Guidelines and AHA Coding Clinic instruction appropriately/accurately
• Discuss diagnostic guidelines and apply clinical validation

Module 7: Evaluation & Management: Professional Services Billing

This module discusses the basic documentation requirements of evaluation and management coding as defined in the both the 1995 and 1997 Guidelines for Evaluation and Management. It also covers the upcoming changes in requirements that go into effect in 2021.

Learning Objectives:

• Define the difference between new and established patients
• Define the term Relative Value Units
• Explain the documentation requirements/required components for all E/M levels
• Discuss CDI efforts to assist with E&M levels

Module 8: Quality Reporting

This module reviews quality reporting measures that impact providers in the outpatient setting to include Healthcare Effectiveness Data Information Set (HEDIS), Medicare Access & CHIP Reauthorization Act (MACRA), and Merit Based Incentive Payment System (MIPS). Alternative Payment Models incorporating risk and quality are also discussed such as Accountable Care Organizations and patient Family Centered Medical Homes.

Learning Objectives:

• Describe the purpose of HEDIS Measures
• Discuss the types of measures monitored within HEDIS measures
• Describe MACRA and MIPS Reporting
• Discuss Alternative Payment Models
• Identify how CDI function can offer impact to the above quality measures

Module 9: CDI Function in Charge Capture

This module discusses the function of CDI in the outpatient setting related to charge capture. We discuss activities related to denials management, medical necessity of care such as work related to National and Local Coverage Determinations. Charge capture related to observation charges, injections/infusions and chargemaster are discussed.

Learning Objectives:

• Discuss the role of CDI in denials management
• Define the purpose of NCD/LCDs and how they can be used to promote supportive documentation
• Discuss reimbursement related to observation status and how CDI can assist with accurate capture
• Define the term Chargemaster and functions to manage charge practices

Module 10: Physician Engagement & Education

This module reviews CDI activities related to physician engagement and education.

Learning Objectives:

• Discuss the challenges related to provider education in the outpatient setting
• Develop a provider education plan
• Identify key concepts to include in provider education
• Explore educational strategies to successfully communicate concepts

Module 11: CDI Metrics, Ethics & Compliance

This module discusses common metrics used to measure and communicate the impact of CDI efforts. We review efforts to minimize vulnerability and to understand the functions government audit agencies, office of the Inspector General and the False Claims Act. The ACDIS Code of Ethics is reviewed.

Learning Objectives:

• Discuss common metrics used to measure CDI impact
• Review the ACDIS Code of Ethics
• Describe the function and focus of the following audit initiatives
• Comprehensive Error Rate Testing
• Recovery Auditors
• Program Safeguard Contractors and Zone Program Integrity Contractor
• Office of Inspector General
• Medicare Administrative Contractor
• Commercial Audit
• Risk Adjustment Data Validation
• Wrap up and Question/Answer/Discussion (30 minutes)

Module 12: CCDS‐O Exam Preparation

This module ends the course with a discussion of the CCDS‐O exam, prioritizing preparation needs and the test taking experience.

*Agenda is subject to change.

CDI for Outpatient Boot Camp

Questions/Answers

What is the focus of the CDI for Outpatient Boot Camp?
The CDI for Outpatient Boot Camp is a three-day, classroom-based intensive training course that will teach outpatient CDI and coding specialists the skills necessary to succeed in their jobs. It focuses on:

• Common diagnoses impacting hierarchical condition categories (HCCs)
• Record review and query
• Medical necessity documentation
• CDI role in charge capture
• Ethics and compliance 

The CDI for Outpatient Boot Camp will also benefit organizations with established outpatient CDI programs that need additional development.

Where is the course offered?
Open registration courses are offered at various locations around the country, typically at mid-priced business hotels such as Hyatt Place or Hilton Garden Inn. For a current schedule of upcoming open registration courses, click on "Course Locations/Dates".

In addition to our open registration courses, we also offer the CDI for Outpatient Boot Camp as an on-site course (with a substantial discount) for organizations that have a number of employees who need training. For more information on hosting an on-site course at your facility, call 800-650-6787 or email customer@simplifycompliance.com.

In addition, we offer the CDI for Outpatient Boot Camp online. Please click here for more information.

What if I need to cancel or transfer my registration?
To view our cancellation policy, click here.

What material does the course cover?
To view the course outline, click on "Course Outline" above.

Does the course require any previous experience or training?
No. However, because of the course's fast-paced nature, it is recommended (but not required) that participants have at least one year of experience working in a hospital. This course is taught on a basic to intermediate level.

Who should attend?

• Clinical documentation improvement (CDI) specialists
• CDI managers/directors
• Coding compliance directors/managers
• Coding compliance specialists
• Outpatient coders
• HIM directors
• Revenue cycle directors
• Physician champions/advisors to CDI
• Quality improvement professionals
• Coding managers/supervisors
• Denials and appeals managers
• Compliance officers

Is there a discount for ACDIS members?
Yes. ACDIS members save $150 off the registration fee. Call 800-650-6787 to receive your discount or click here for more information.

How is the course taught?
The course is taught using a combination of lecture, class discussion, and hands-on exercises/case studies.

What do I need to bring to class?

• Highlighter
• Sticky notes
• Pen/pencil

Does HCPro ever share contact information (e.g., name, address, phone number, email address, etc.) with other companies?
Historically, we have not shared contact information with anyone outside of our company. However, it is possible that at some point we might share contact information with other companies that offer products and services that we think would be of interest to our customers. If you would like us to keep your contact information confidential, please let us know so that we can flag your information in our customer database as "Do Not Share."

How do I get more information? 
Contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

CDI for Outpatient Boot Camp

Things to Know Before Attending Class

Directions and Hotel Information

The hotel address, phone number, URL, room rate and room rate cut-off date are posted on the Locations/Dates tab. The hotel websites give detailed directions to the hotel as well as information about the location. Please call the hotel directly to make a room reservation. Be sure to identify yourself as an HCPro Boot Camp participant. Please be sure to make your reservation before the cut-off date. After the cut-off date, contact the hotel to determine room availability and rates.

Course Materials

When you arrive at class, you will receive two books containing the class materials utilized throughout the boot camp. These books will be yours to keep, so plan accordingly in allowing enough room in your luggage on the return trip home. The books weight approximately 5 pounds. Books may also be shipped from the hotel at your own expense.

Classroom Time

Other than short breaks and lunch, we will be in class from 8:00 a.m. to at least 5:00 p.m. each day. In order to focus all attention on the course and to not distract other participants as well as the instructor, cell phone use during class is strictly prohibited. We will take short breaks (up to 10 minutes each) throughout the day that will give participants an opportunity to make calls, use the restroom, etc., in addition to an hour lunch break for lunch on your own.

Lunch

We will take about a 45-minute break for lunch each day. We typically provide coffee in the morning and drinks and a light snack in the afternoon, everyone is on their own for lunch. Note that many hotels do not have restaurants on-site. If you are flying to the course, we generally recommend renting a car, or investigating availability of hotel shuttle or ride share.

What to Bring to Class

Please bring the following to all classes:

• Highlighter
• Notepaper
• Sticky Notes/flags
• Pen/Pencil
• Layered clothing (e.g., light sweater, light jacket, etc.)

Dress

Business attire is not necessary. Please dress comfortably. Sometimes classrooms are on the cool side, even during the warmer months. You may be more comfortable if you bring a sweater or sweatshirt in case you get cold.

CCDS Examination Information

The Association of Clinical Documentation Improvement Specialists (ACDIS) offers a certification for CDI specialists, the Certified Clinical Documentation Specialist (CCDS-O). We recommend the CCDS-O exam for individuals who desire to pursue certification. However, the course may not cover all the content areas tested on the exam. Additionally, the certification requires experience performing the duties of a CDI specialist so attending this class may not qualify you to sit for the exam if you are new to the field of CDI.

Consequently, depending on your background and experience, additional independent study and/or training may be required to pass the CCDS examination. To download the CCDS Candidate Handbook and Application and view the prerequisites, visit the ACDIS website at https://acdis.org/certification/ccds-o.

Cancellation and Transfer Policy

For our cancellation and transfer policy, visit our website: http://hcmarketplace.com/cancellations

COVID Safety

Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

• If the region where our event is located is deemed by the CDC to be within the substantial or high-risk category, we will require all attendees, regardless of vaccination status, to wear masks when indoors except while actively eating or drinking. 
• Meeting rooms will be set to support social distancing when necessary.
• Food service will follow the safety guidelines implemented by the hotel.

To view all the safety measures that a specific hotel has implemented, please see the information listed on their website.

Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines, and will communicate adjustments to the onsite policies and procedures as necessary.

Contact Information

For more information about our Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

We Look Forward to Having You In Class!

CDI for Outpatient Boot Camp

Continuing Education

AAPC
This program has prior approval of the AAPC for 21 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the AAPC of the program, content or the program sponsor.

ACDIS
This program has been approved for 21 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification and CCDS-O (outpatient) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).

AHIMA
This program has been approved for continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting of Approved CEUs from AHIMA does not constitute endorsement of the program content or its program provider.

ANCC
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 21 nursing contact hours is provided by HCPro.

CDI for Outpatient Boot Camp

COVID

Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

• Per current CDC guidelines, if the county where our event is located is deemed to be within the high level of COVID-19, it will be recommended that all attendees, regardless of vaccination status, wear masks when indoors except while actively eating or drinking.
• Food service will follow the safety guidelines implemented by the hotel.

To view all the safety measures that a specific hotel has implemented, please see the information listed on their website.

Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines and will communicate adjustments to the onsite policies and procedures as necessary.