Real results: An organization boosted by Custom Edits

  • What are Custom Edits?

    The Custom Edits function, available in 3M’s coding systems, allows organizations to create coding edits unique to their needs and incorporate them into the coding workflow.

    What value do Custom Edits bring?
     

    • Edits occur in the coder workflow instead of in the EHR, which helps reduce audit time and improve accuracy
    • Edits can be tailored to meet the requirements of payer contracts that are specific to a facility
    • Custom Edits support on-the-job training by incorporating essential checkpoints into the coding workflow based on the organization’s unique coding needs
    • Depending on the Custom Edit’s severity ranking (set by the organization), the coder can be notified about specific hospital needs and prevented from completing a record until the edit is resolved, thus increasing accuracy and reducing rework

    Download the full case study (PDF, 1.1 MB)


The following is a profile of an organization that saw real results within eight months of implementing Custom Edits in its 3M coding system.
  • Their story

    This university medical center recently implemented a new EHR and underwent organizational structure changes to its coding team. During these changes, the organization set goals to improve its coder performance, reduce its discharged not final billed (DNFB) rate and increase diagnosis specificity rates for common problem areas. And, as a Vizient® member, a healthcare performance improvement company, the medical center was also motivated to improve its performance in Vizient-focused areas.

    The medical center needed a tool that could provide customized coding edits tailored to its specific business needs. It determined that the Custom Edits function in their 3M coding system was a perfect fit.

    The medical center, a long-standing 3M client, implemented Custom Edits without technical issues and quickly began to see improvements.

  • Hospital icon

    Hospital profile

    Location: Southeastern U.S.
    Type: Independent, non-profit university medical center
    Beds: 800+
    Hospital statistics: 30,000+ surgeries | 1,500,000+ ambulatory visits | 60,000+ ER visits

Their results with Custom Edits

  • Thumbs-up icon
    Vizient score performance improvement
  • Icon of clipboard with arrow pointing upwards
    0.6 increase in case mix index
  • Icon of an arrow in a circle pointing upwards
    10.1% increase in Acute Kidney Injury (AKI) specificity rate

Successful Custom Edits

  • Example one: “Vizient Sepsis code” Custom Edit

    Business need:
    The medical center uses over 20 different Custom Edit messages related to their Vizient needs. The edit topics include cardiac arrhythmia, chronic liver disease, sepsis, malnutrition, respiratory failure, acute renal failure, chronic kidney disease, etc.

    The medical center pays close attention to these Vizient-related codes because they are tracked for quality performance in Vizient’s member-driven performance improvement system.

    How the Custom Edit was implemented:
    When the “Vizient Sepsis code” triggers, the Custom Edit in the 3M coding system instructs the coder to query the physician for symptom confirmation before continuing the coding session.

    The medical center ranks this Custom Edit as “high severity,” which prevents the coder from completing the record until the issue is resolved.

    Real Results:
     

    • Vizient score performance improvement
    • Coders are capturing more diagnoses they might have otherwise missed (especially when working in a different or unfamiliar specialty)
    • Coders are querying the physician when alerted to confirm the symptoms for Vizient reporting
    • Increased accuracy, decreased rework and a faster ramp-up when cross-training coders
  • Example two: “Invalid newborn diagnosis” Custom Edit

    Business need:
    The medical center saw a large increase in births from 2,500 to over 3,800 in just three years. With this dramatic increase in births, a recurring quality issue began to appear: An invalid maternity admit diagnosis code was commonly being entered by the nursing staff.

    The “invalid newborn diagnosis” CustomEdit was put in place so the coders could catch the incorrect diagnosis code and enter the correct one.

    How the Custom Edit was implemented:
    When the “Invalid newborn diagnosis” Custom Edit triggers, it instructs the coder to correct the newborn admit diagnosis before continuing the coding session.

    The medical center ranks this Custom Edit as “normal severity,” which does not prevent the coder from completing the record before resolving the issue.

    Real Results:
     

    • This Custom Edit allowed them to catch the incorrect newborn diagnosis at the time of coding
    • Coders have become more aware of this problem area and are querying more often
    • This Custom Edit had a significant impact on the efficiency and accuracy of the maternity coding process
  • Other improvements at the medical center include:

    • Coders spend less time transferring back and forth between the EHR and 3M systems to make corrections
    • Claims are generated and out-the-door more quickly
    • Cleaner claims are going out
  • More real results

    Custom Edits helped this medical center achieve its organizational goal of improving the accuracy of diagnosing Acute Kidney Injury (AKI) versus Acute Tubular Necrosis. The results below demonstrate the AKI specificity improvement the organization saw over a period of eight months.

    Real Results:
     

    • Medical center target AKI specificity rate: 15%
    • Actual AKI specificity rate eight months after implementing Custom Edits: 18.7%
    • Total AKI specificity rate increase: 10.1%

The value of Custom Edits

  • In its 3M coding system, the medical center uses 28 unique Custom Edits created for various purposes. Custom Edits give the organization the flexibility to turn off certain edits as they become unnecessary and turn them back on as needed for training, accuracy or other reasons, depending on each Custom Edit’s purpose.

    The medical center has seen real results and received high value from the Custom Edits feature.


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  • *3M is a trademark of 3M Company. Vizient is a registered trademark of Vizient, Inc.