Definition
Clinical Documentation Improvement (CDI) is a discipline that ensures provider documentation accurately reflects the patient’s severity of illness, risk of mortality, and services delivered so coding and billing are correct and compliant. CDI teams clarify diagnoses, procedures, and clinical indicators to support ICD-10 and CPT coding, MS-DRG assignment, and medical necessity. For example, clarifying "acute on chronic systolic heart failure" instead of unspecified CHF can increase MS-DRG weight and revenue by $500–$2,000 per inpatient case and lift Case Mix Index (CMI).
Why it matters
Across large health systems, even a 0.05 increase in CMI can translate to $5–$10M in annual revenue on a $500M net patient revenue base. Strong CDI also reduces clinical denials and rework; organizations commonly see 10–20% fewer medical-necessity denials when documentation is precise.
How Ventus helps
Clinical documentation stays with your providers and CDI team. Ventus supports the payer side: it identifies which procedures need pre-authorization and assembles requests to each payer's requirements, with codes, attachments and a narrative.
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