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ICD-10-CM/PCS News Archives

Rely on coding audits to improve productivity, increase coder satisfaction

December 1, 2015:

ICD-10 not only changes the way you do coding and documentation. It also affects the way you should be approaching coding audits.

Provider leaders have been warned for years about potential for productivity loss under ICD-10. The first two months of ICD-10 results have shown us that while the new code set indeed has a negative effect on coder proficiency, education and training are the key to remediating that loss.

In fact, we’re finding that coders want ICD-10 education. Those who had been coding under the ICD-9 system for 10, 20 or even 30-plus years are in unfamiliar territory, and they want to get back to feeling competent. In this way, education should become part of an organization’s coder retention strategy.

Coders are in high demand, and have plentiful opportunities to solicit for other positions. Giving them the education they’re looking for and helping them feel like they're experts again can provide increased job satisfaction.

To bring productivity back up to par as well as provide focused education, you need coding audits. Consistent audits will tell you where there are gaps in coding accuracy and coding efficiency, and it will provide a starting point for producing custom education that is designed to remediate your coding gaps.

But just like coding standards have changed, coding audit standards need to change as well under ICD-10. Because ICD-10 coding is more complex, old methods need to be rooted out and replaced with new approaches.

Identifying accounts to be reviewed – Finding the right records to review can be a manual, time-consuming process. Find ways to automate this process, focusing on pulling records from your database that meet criteria you find important.

Extracting coded accounts to avoid manual data entry – Organizations that are pulling accounts manually are bogging down the auditing process twice, since manually pulled accounts have be manually entered in to the auditing tool and/or database.

Internal resource time and skills to perform audits – Within the facility, what resources are available and qualified to perform audits? Some of those resources will be pulled off of audits to remediate coding productivity or other issues. Or, those resources may not feel they have the coding time or experience to be able to audit their peers. It’s important to have a qualified, dedicated resource.

Technology to support audit results – Make sure you have access to tools that allow you to track audits. You need to know details of such results—by coder, specialty, provider, etc.—and be able to trend that over time.

Focus on current issues – If you knew the issues to audit under ICD-9, what are the issues now? Are there coding errors that are causing trouble? Do certain specialties need to be watched over? Is PCS an issue?

Be aware of payer target areas – Payers often publish their target areas, but all too often, providers don't take the time to look at target areas or follow any changes online.

If following the above guidelines with your internal resources seems unlikely for your organization, consider partnering with an external organization that can perform the audits. Make sure they are flexible enough to increase auditing if they find issues and skilled enough to create custom education based on findings and results.

Coding audits are perhaps more important now than they were under ICD-9. Before errant practices become bad habits, now is the time to begin regular inpatient coding audits.


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