Some upcoming Nurse Alliance Information and Educational Opportunities

1. Charge Nurse Workshop
10/26/09
Edited 12/21/09 by Jessica
Donohue, RN
Adjusted for med-surg units 7a,8d

2. What are Accommodation Codes?
 Da (2 hrs P tie BillingAs ig e m d b the
ily 4 .) a nt s nm nts a e y
RN a s ne to e c p tie viatheNurs Op ra ns
s ig d a h a nt ing e tio
Da b s (NOD)
ta a e
 Inte iveC re Inte e ia C re Ac C re Nurs ry
ns a , rm d te a , ute a , e
Le lsI-IV
ve
 In thes m r o 0 ’ ho p l ins
um e f 8 the s ita titute nurs
d e
s ffingra sb s dup n tw c ria
ta tio a e o o rite .
 1. Thep tie
a nt'ss ve o illne sa
e rity f s nd
 2 Theinte ity o nurs rve
. ns f inginte ntions
 Thep d t us db MUHA w h s tsthes rting
ro uc e y hic e ta
s nd rdfo thisisc lle Inte
ta a r a d rQua (Nurs rie us DHEC
l e s e /
Me ic idg e s
d a uid line )

3. InterQual? Tell me more
 InterQua e e e a e c
l vid nc -b s d linic l d c io s p rt
a e is n up o
c riaa us db tho a so o a tio in
rite re e y us nd f rg niza ns
he lthc re
a a .
 Us dtoa w r c a q s nsa o the
e ns e ritic l ue tio b ut
a p p te s o le lso c rea re o eus
p ro ria ne s f ve f a nd s urc e

4. How does InterQual apply to
nursing activities?
 Dr. C w y, o Exe utiveMe ic l Dire to b g n
a le ur c d a c r, e a
c iringa Inte
ha n rQua m e
l e tingin Se te b r 2 0 .
p me 0 8
 Thep o eo thism e
urp s f e tingis:
 To re wre ue tsfo c ng s
vie q s r ha e
 P vid c ns te y in d c io m kingw n
ro e o is nc e is n a he
a w c ng s
llo ing ha e
 Ens tha c
ure t linic l c riaa theb s fo c ng
a rite re a is r ha e

5. How To Get Involved
 Nurs m na e a invite toa ndthe
e a g rs re d tte
InterQua Me tinge ry o r Mo a a 10 0a in ro m
l e ve the nd y t :0 m o
2 5MH.
9
 Sta RNsa w lc m toa ndw the m na e top s nt
ff re e o e tte ith ir a g r re e
a p tie nurs c reind a rstha m y w rra ac ng .
ny a nt ing a ic to t a a nt ha e
 TheInte rQua C m itte s nd are w dlis o ind a rsto
l o m e e s vie e t f ic to
thenurs m na e p rio ic lly w up a sa it isp s d
e a g rs e d a ith d te nd o te
o theNOD.
n
 he yo s le t theInte
W n u e c rQua ind a rs yo a d te ining
l ic to , u re e rm
p rt o thep tie sb
a f a nt’ ill.

6. To Ensure Appropriate
Billing Practices
 InterQual indicators should never be selected
unless actual care has been provided and
documented.
 InterQual criteria must be entered into the
Nursing Operational Database (NOD) by 10:00 pm
daily.
 P tie a b d a m nig b s d o the m nig to
a nts re ille t id ht a e n ir id ht
m nig c re(2 ho ) fo theC
id ht a 4 urs r URRENT d te
a .
 Afte 10 0p , if thep tie c nd n c ng sfro
r :0 m a nt o itio ha e m
routinetointe e ia s tuse r thene c riaand
rm d te ta nte w rite
no theAd it Tra fe C nte s the m y a jus b
tify m ns r e r o y a d t illing
p r tom nig
rio id ht.

7. To Ensure Appropriate
Billing Practices
 No patient should have “not done” in the
Accommodation Code column.
 Audits of the records for the following indicators
have frequently shown no supporting
documentation:
 Ne lo icAs e s e (a ind a rs
uro g s s m nts ll ic to )
 Anti-Infe tive (a ind a rs
c s ll ic to )

9. Accommodation Code
Assignments
 RNss le t s nd rdc riatojus theinte e ia
e c ta a rite tify rm d te
a c m o a n c d a s nm nt, if a p a le
c o m d tio o e s ig e p lic b .
 Anytim d
e uringa2 ho (m nig tom nig p rio a
4 ur id ht id ht) e d
p tie m e inte e ia c ria theRN w a s n the
a nt e ts rm d te rite , ill s ig
inte e ia a c m o a n c d .
rm d te c o m d tio o e
 Charge Nurse verifies at 10:00pm tha a c m o a n c d s
t c o m d tio o e
a re w da p p rly a s ne fo e c p tie (C rg
re vie e nd ro e s ig d r a h a nt. ha e
Nurs Re o
e p rt)
 Any criteria selected must be documented in the
patient record.

10. Access to Nursing Operations Database
 C k o Nurs Op ra nsDa b s IC
lic n ing e tio ta a e ON o r
 Link o thefro p g o theMe ic l Ce r Intra t
n nt a e f d a nte ne
(fre ue
q ntly us d links
e )
 Typ OAC Lo In
e IS g
a P s w rd
nd a s o

12. Click

14. Click

16. Click

17. Click

18. Click

22. Charge Nurse Verifies Accommodation
Code
 Every evening at 10:00pm the charge RN must verify that
every patient has an accommodation code.
 Eve nig a m nig (a r thep tie sd y ha b e b d
ry ht t id ht fte a nt’ a s e n ille )
thea c m o a n c d a s nm nt fo e c p tie d fa
c o m d tio o e s ig e r a h a nt e ults
b c to“ t Do ” ta .
ak No ne s tus
 C ll Ad is io Tra fe C nte (ATC if thep tie ha b e
a m s n ns r e r ) a nt s e n
d c rg da re a o thero te (Rig P tie Rig
is ha e nd m ins n s r. ht a nt, ht
Be )
d
 C ll ATC (2 3 6 if ap tie o c ie ab dtha isno o the
a -3 0 ) a nt c up s e t t n
ro te
s r.
 If p tie c nd n c ng sb tw e 10 0 ma m nig
a nt o itio ha e e e n :0 p nd id ht,
c ll ATC a up a thea c m o a n c d c ria
a nd d te c o m d tio o e rite .

25. Changing Codes that have been Entered
 Me -SurgAre s
d a
 Inte e ia to Ro
rm d te utine
 Ac o m d tio Co eRe o - Me -Surg
cm oa n d p rt d
 “ ha e o tio a ila le(und r “d c lum if c d c ng s
C ng ” p n va b e e it” o n) o e ha e
a re uire (e . if a c e lly e re fo w ngp tie
re q d .g c id nta nte d r ro a nt)
 “ ha e o e up there o s tha yo c n up a p vio ly
C ng ” p ns c rd o t u a d te re us
s le te info a n
e c d rm tio
 Routineto Inte e ia
rm d te
 C k o “ utine o tio (und r “c o m d tio c d ” o
lic n ro ”p n e a c m o a n o e c lum n)
a s le t up a d ind a rsto c ng a c m o a n c d
nd e c d te ic to ha e c o m d tio o e
a s nm nt
s ig e
 IC s
U’
 C k o “ U” “
lic n IC , Inte e ia (IC
rm d te U)” r “ utine o tio (und r
o Ro ”p n e
“c o m d tio c d ” o n) a s le t up a d ind a rsto
a c m o a n o e c lum nd e c d te ic to
c ng a c m o a n c d a s nm nt
ha e c o m d tio o e s ig e

26. Summary Questions
 Only RNsc n a s n Ac o m d tio
a s ig cm oa n
C ds
o e.
(TRUE)
 Thea c m o a n c d re c thep tie
c o m d tio o e fle ts a nt
c rere e d fro m nig to m nig
a c ive m id ht id ht.
(TRUE)

27. Summary Questions (cont.)
•It iso y to le veap tie a c m o a n
ka a a nt c o m d tio
c d a “ t Do ”
o e s No ne .
(FALSE)
 Any c rias le te m t b d c e din thep tie
rite e c d us e o um nte a nt
re o .
c rd
(True)

28. Summary Questions (cont.)
 Billingap tie a a inte e ia d le l w ut
a nt t n rm d te ve itho
a p p ted c e tio isc ns e d b
p ro ria o um nta n o id re illingfra .ud
(True)
 A c ntinuo p eo o a ne m nito
o us uls x r p a o ringre uire a
q s
d c rso e tob w n in thec rt in o e fo the
o to rd r e ritte ha rd r r
p tie to b a a inte e ia le l?
a nt e t n rm d te ve
(True)

29. Summary Questions (cont.)
 If thep tie ha ano a g e ngtub , iso NG fe d
a nt s rm l tub , e n es
o ha Gtub m d , yo c n c c tha the ha GI
r s e e s u a he k t y ve
s tio ra g .
uc n/d ina e
(True)