5 Proven Medical Coding Strategies to Improve Vizient Scores

Vizient scores are a key benchmarking tool for hospitals across the United States, but coding and documentation gaps can quietly distort PSI rates, mortality metrics, and resource utilization. While not every Vizient measure is coding-driven, inaccurate principal diagnosis selection, incomplete comorbidity capture, and POA errors can misrepresent a hospital’s true performance.

Read this blog to learn five practical coding strategies hospitals can use to protect data integrity, validate risk adjustment, and ensure Vizient outcomes accurately reflect the care being delivered.

Vizient scores offer hospitals a benchmark for comparing clinical outcomes, efficiency, and patient safety with peer institutions. While not every metric within Vizient’s Quality and Accountability Ranking is directly influenced by coding, inaccurate or incomplete coding can distort key measures—particularly those related to patient safety indicators (PSIs), mortality, and resource utilization. That’s why a strategic approach to coding is essential to ensure data integrity and help your facility present the most accurate picture of its performance.

Here are five proven strategies to help your coding team support stronger Vizient outcomes:

1. Strengthen SOI and ROM Accuracy Beyond CC/MCC Capture

• Strategy: Go beyond just CC/MCC capture. Conduct targeted reviews to assess whether the principal diagnosis is clinically appropriate, secondary diagnoses are fully captured, and procedures are coded to reflect complexity. Educate coders on high-impact clinical indicators (e.g., acute organ dysfunction, shock, sepsis, respiratory failure) and partner with CDI to ensure documentation supports accurate code assignment. Consistent reviews of high-volume DRGs can help prevent underreporting that suppresses SOI/ROM.

2. Target PSI-Related Coding Issues

• Strategy: Prioritize internal audits and education around PSI-prone DRGs, procedures, and conditions. Make sure POA indicators are not defaulted and that coders know when a condition truly qualifies as a reportable complication versus an expected outcome.

3. Collaborate Proactively with CDI

Coding accuracy can only go so far without strong clinical documentation. CDI and coding should work hand-in-hand, especially for Vizient-impacting measures like mortality reviews and length of stay.

• Strategy: Establish a feedback loop between CDI and coding teams for shared reviews of high-risk cases. Joint case reviews help ensure agreement on principal diagnoses and that severity is appropriately captured.

4. Audit High-Risk DRGs for Mortality Metrics

Certain DRGs—such as those involving sepsis, respiratory failure, and cardiac events—are heavily weighted in Vizient’s mortality score. Coding inconsistencies here can skew expected versus actual mortality outcomes.

• Strategy: Perform DRG-level audits focused specifically on Vizient mortality drivers. Look for misassigned principal diagnoses, underreported comorbidities, and missed opportunities to reflect the true acuity of care.

5. Use Your Data to Drive Continuous Improvement

The most effective organizations regularly review their coding performance against internal benchmarks and peer comparison tools like Vizient’s. Data without context is a missed opportunity.

• Strategy: Use dashboards or tools (like Atom Audit) to visualize coding accuracy, denial trends, and case mix data. Regularly analyze where documentation or code selection may be suppressing your scores—and act before year-end data freezes.

Final Thoughts

While not all Vizient metrics are within a hospital’s control, coding and documentation integrity are. By proactively identifying gaps, investing in education, and aligning coding efforts with clinical realities, facilities can protect their scores, validate their performance, and ensure they’re being measured accurately against their peers.

Need help with targeted audits or education to support your Vizient goals? HIA offers custom reviews and coding support services designed to give hospitals clarity and confidence in their data. Contact us for more information.

FAQ

For more than 30 years, HIA has been the leading provider of compliance audits, coding support services and clinical documentation audit services for hospitals, ambulatory surgery centers, physician groups and other healthcare entities. HIA offers PRN support as well as total outsource support.

The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.