CDI Code of Ethics: A Call for Integrity and Collaboration

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CDI Code of Ethics I felt compelled to post a quick summary read of the ACDIS & AHMA CDI Code of Ethics, after hearing from some of my CDI colleagues describe the pressure placed on them to review records, issue more queries, capture more CC/MCCs, and generate more revenue. This pressure emanates from CFOs who have been convinced by prominent CDI consulting companies pushing their CDI consulting services and CDI software. Typical claims made by these firms include " we can get you x million dollars every year for the next three years, just sign this contract for x million dollars," or buy our software, "you will achieve 5:1 ROI starting on Day 1: An average of $2.5M in annual net new revenue per 10K patient discharges. CFOs are being misled to believe that CDI is in the business of bringing in more revenue through more queries. More queries without improvement in the quality of physician documentation generate more denials, period. Durable, sustainable net patient revenue is a byproduct of solid physician documentation that reflects the clinical truth-Cesar M Limjoco MD. CDI has, in many respects has lost its way, caught up in coding of CCs/MCCs as opposed to collaborating with physicians to enable and facilitate better documentation. In the process, the profession as a whole is deviating from the ACDIS CDI Code of Ethics 📘 ACDIS Code of Ethics — Core Principles & References 🧭 1. Integrity in Documentation Commitment to accurate, complete, and honest documentation that genuinely reflects clinical care. Prohibition against altering or suppressing information to manipulate outcomes . 👩⚕️ 2. Ethical Query Practice Queries must be neutral, non-leading, and based on clinical indicators. Forbidden: "leading" queries, introducing unsupported diagnoses, or querying when no clinical basis exists. . 💰 3. Avoiding Financial Manipulation No participation in practices that inappropriately increase payment, distort data, or misrepresent medical necessity. . 🎓 4. Ongoing Education & Expertise Maintain and enhance professional knowledge through continuing education, including coding standards and ethical guidelines . 👥 5. Team Collaboration Work collegially with providers, coders, and quality teams. Commit to interdisciplinary education to support accurate documentation and compliant CDI processes. . 🔐 6. Confidentiality & Compliance Strictly protect patient confidentiality and access only necessary health information. Report any unethical, non-compliant, or unlawful behavior through appropriate channels. . ⚖️ 7. Professional Conduct & Reporting Uphold the highest standards of integrity, honesty, and professionalism. Take action against unethical behavior, even among peers. . #CDI, #codeofethics, #moneytalkscodeofethicswalks, #misnomer, #hoodwinkedbyconsultingcompanies

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As a coder working in the outpatient space to improve provider documentation, shutting coders out of the CDI space because “coders aren’t clinical” is a HUGE mistake. I am certified as a clinical documentation expert, a risk adjustment AND a professional coder by my licensing body, and I hold a degree in Healthcare Management. This means I am versed in quality, HCC coding,E/M documentation and the ever changing policies surrounding compliance and coding/documentation. It’s my job to navigate all of that for my network providers and teach them the easiest ways to accomplish what they need to tweak in their workflows to remain compliant, support what they bill, and still keep their clinics running, not pester them with never ending queries. Give them real time, meaningful feedback that makes a difference with helpful tools that actually matter.

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