Diagnosis and Treatment of ICD-10 Coder Productivity

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Let’s face it, we are still commiserating about ICD-10 and we will continue to do so until the next frustrating thing comes along. There is something almost comforting about sitting around comparing scars. After all, we work in healthcare and we are wired to continuously examine the nature of a case, in an effort to detect symptoms and to find a cure.

One of the most recent symptoms of the ‘ICD-10 Aftermath’ is the loss of productivity for coders. We were warned about this well in advance, but what can be done when we were already faced with a sparse field of qualified coders before the transition even took place?

Garbage In, Garbage Out

Hospitals have signed with multiple vendors to try and to manage the workload. This creates a challenge in overall scalability, and creates extra work to ensure processes remain streamlined with multiple hands on deck. Backlogs in coding are starting to appear and this will lead to increased days in Accounts Receivable, which then impedes cash flow. And then, of course there is an increase in denials due to the general lack of knowledge in the industry as a whole.

Some hospitals have moved to computer assisted coding to make coding easier and to improve productivity, as well as accuracy. This is beneficial when coders and physicians are properly trained on the content and documentation required for accurate input. Just like all applications, this one is garbage in, garbage out.

Other hospitals are sending the work off-shore to fill the gap. However, concerns remain around security, quality and accuracy, despite the ongoing effort to improve policies and procedures, increased audits, and tightened service level agreements.  The ongoing emphasis placed on quality indicators and the increasing need for dialogue between clinicians and coders further complicates the ability to send work off shore. Time zone gaps and communication efforts simply prove to be cumbersome at best.

Enter Education

Education remains one of the most obvious remedies to improve accuracy and coder productivity. This includes multiple levels of training to address all of the points of impact.

o   Training entry level coders historically proficient in ICD-9 –with a short supply of qualified coders, entry-level ICD-9 trainees already offer a level of experience and productivity to collect, analyze, and translate efficiently – why not capitalize on this experience with an extra layer of education?

o   Cross training coding staff – it is never too late to combine forces of inpatient and outpatient coders.

o   Educating physicians on documentation improvement – this effort increases the granularity of physician information, which will have a direct impact on the potential accuracy of computer assisted coding.  

With much of the training found in online, on-demand course work, updated education is literally at our fingertips and available for consumption on our own timelines. With this additional training and the resulting boost in your internal knowledge base, you can ease the burden of a strained workforce and turn that lagging productivity into efficiency and improved clinical communication.