22 Apr Eight Standards of ICD-10 Coding
The International Statistical Classification of Diseases and Related Health Problems (ICD) now is on the 10th revision, making ICD-10 the new kid in town. This code set allows for more than 14,400 different codes, permits the tracking of new diagnoses, and codes for signs/symptoms, complaints, social circumstances, abnormal findings, diseases, and external causes of disease/injury. Here are 8 standards regarding ICD-10 coding.
No. 1: Prepare for a Slowdown
ICD-10 was implemented on October 1, 2016, and many healthcare facilities have experienced a slowdown. Many industry experts have predicted a 50-70% drop in coder productivity initially. Coders have been able to code 1.5 inpatient charges per hour working with ICD-10-CM/PCS, according to productivity investigators. In addition, the codes are different than ICD-9, and they have to be built, which relies on interpretation of the provider’s documentation. The best way for billing companies and physician practices to gauge ICD-10’s impact on coder productivity is to have coders code using the ICD-10 system, assess productivity, and then repeat.
No. 2: Practice, Practice, Practice
To eliminate or alleviate productivity losses, the coding department should practice. This is the most effective way to ensure that coders are ready for ICD-10. Coders practice time and duration should be based on individual coder assessments. Focus on specific diagnoses and procedures, such as high-risk diagnosis-related groups. Practice sessions should involve several records per week. The quality of coder training is as important as the duration. Also, anatomy and physiology ranks near the top of training objectives.
No. 3: Reserve Additional Help
Because coding will be more complex using ICD-10-CM/PCS, you will need more billers and coders. Many physician practices choose to outsource billing and coding because of the complexity of the process. Some coders may leave the field due to the complexity of billing with the new system. Experts estimate that around 25% of professionals will leave the field, causing an industry shortage. Because it could affect your revenue, you should consider making prior arrangements.
No. 4: Consider Workflow Changes
You can capitalize on your coder’s strength to improve efficiency. With MPMR Medical Billing, we route billing assignments to specialty coders who work in cardiology, radiology, gastroenterology, and more. Accuracy requires coder specialization, and it makes sense that the coder understand all the body systems related to their specialty.
No. 5: Review “Discharged Not Final Billed (DNFB)
Having many discharged not final billed claims is a problem for coders shifting to ICD-10. Some hospitals rely on coders who specifically focus on DNFB. This allows the assigned coders to clean up ICD-9 backlogs, and to concentrate on ICD-10. Staggering the training times will allows one coder to work on the DNFB while others can be trained.
No. 6: Consider Computer-Assisted Coding (CAC)
Computer-assisted coding will increase coder efficiency. If coders are adequately trained in ICD-10, and have time to practice, they will become more efficient. Computer-assisted coding is only as effective as the documentation. The physicians should offer adequate documentations. Most of these coding programs are often built for ICD-10 readiness. Computer-assisted coding prevents productivity problems.
No. 7: Talk with Payers
Initiate communication with your top payers. Inquire about denial strategies, difficult codes, and claim submission errors. CMS will conduct an end-to-end testing series, so you will have the opportunity to discuss problems with vendors, payers, trading partners, and clearinghouses. Anything a coder can do to prevent errors or snags in advance will help the billing process.
No. 8: Plan for the Future
Experts advise that coder productivity will not return to pre-ICD-10 levels for several months. The more specific coding requires time, and that can have a downstream effect on overall productivity. The best strategy is to audit the coders frequently, especially during the first six months. Quality of coding depends on audits, compliance, accuracy, and documentation. With MPMR Medical Billing, our coders have planned for the ICD-10 billing transition, and have mastered the system, allowing for a continued revenue cycle flow.