Policy & Regulation News

3 Tips to Retain Coders’ Productivity Post-ICD-10 Transition

By Jacqueline DiChiara

- Will a projected decline in coding efficiency become reality, perhaps caused by ICD-10’s greater specificity and high code volume? Will ICD-10's implementation kick off with a financial bang or merely a shrugged off whimper? Is the healthcare industry’s most intelligent approach come October 1 to simply keep calm and code on?

ICD-10 implementation deadline coders

The answers are perhaps still very much up in the air. Only 2 percent of claims during Medicare’s recent end-to-end testing weeks were denied because of ICD-10 coding errors. As HealthITAnalytics.com reported, it is possible some of these claims were erroneously coded on purpose. Nonetheless, if an electronic health record/billing system fails to support dual coding, the notion of flipping a switch come October 1 and expecting coders to keep up is perhaps not a reasonable consideration, as RevCycleIntelligence.com reported.

In light of the above ICD-10 questions and concerns, Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, Senior Director of HIM Practice Excellence, Coding, and CDI Products Development at American Health Information Management Association (AHIMA), presents her top 3 ICD-10 strategies to help coders maintain their productivity levels come October:

Train, train, train

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  • According to Endicott, the best method of maintaining high productivity levels during the ICD-10 transition is to ensure coders are intelligently and efficiently trained, well beyond what a simplistic one-day or one-week educational session, albeit intensive, can offer.

    “Effective training involves continuous, ongoing practice in applying ICD-10-CM/PCS codes to actual patient health records,” maintains Endicott. “Many organizations have been doing dual-coding or double coding for the past 6-12 months, which is an excellent method to really learn the nuances between ICD-9-CM and ICD-10-CM/PCS. It may not be practical to dual-code EVERY chart, but even just a couple charts per day is better than doing nothing at all,” she adds.

    Up the hiring ante

    Some are often reluctant to hire recent college or university graduates for general fear their lack of professional experience will hinder future performance. Perhaps the opposite perspective is the best approach, says Endicott. She confirms recent graduates often possess stronger, more current educational knowledge than those already active in the healthcare industry. Coding times have changed and being only familiar with the new instead of the old may prove quite beneficial, she implies, and help the industry stay a step ahead of the coding curve.

    “There are over 200 associate’s degree programs in the US accredited by the Commission on Accreditation for Health Informatics and Information Management Education. Graduates from CAHIIM-accredited colleges and universities must meet rigorous standards and achieve a very high level of coding proficiency,” advises Endicott. “Those students that graduated in the spring/summer of 2015 will be perfectly poised to meet the industry’s demands of skilled ICD-10-CM/PCS coders. They also won’t have the added baggage of years of ICD-9-CM knowledge weighing them down,” she maintains.

    Computer-assisted coding (CAC) is king

    “CAC can assist in assigning the codes from the documentation up front, and then the coders are able to verify the validity of the codes in an auditor-type role. After some time and practice with CAC systems, coders are typically able to increase their productivity significantly,” explains Endicott. “However, implementing CAC and ICD-10-CM/PCS simultaneously is probably not the best tactic. Coders will need time to assimilate to the CAC system and become comfortable with the way it works. Organizations should consider implementing CAC well in advance of, or even after, ICD-10 implementation to ensure that coders are not over-burdened with too many changes,” she states.

    Final thoughts: "very small" productivity loss predicted

    According to Endicott, outpatient coders can expect a “very small” productivity loss, as both ICD-9-CM and ICD-10-CM codes share similar guidelines, structures, and uses. It is hopeful the implementation of the above suggestions will create actionable, positive change come October 1, 2, and well beyond. In the words of Endicott, “Keep calm and code on!”