clinical documentation improvement

Clinical Documentation Improvement (CDI) Specialists play a critical role in helping physicians and healthcare organizations decrease denied claims by improving the quality of documentation in the patient record. Not only does this improved document support ICD coding but also is used to ensure patient safety and quality indicators, which will impact third party value-based purchasing initiatives.

Since healthcare has transitioned from ICD-9-CM to ICD-10-CM/PCS, CDI Specialists will be working even more closely with physicians and coders to increase their understanding of how ICD-10-CM/PCS changes the depth of documentation needed.

Learning about CDI (Clinical Documentation Improvement) is a critical function in healthcare. Accurate and effective coding is a critical component of any successful CDI Program. It is important as a coder to fully understand how coding and CDI work together to improve the quality of documentation.

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