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ICD-10-CM/PCS News Archives

Tips to improve your ICD-10 documentation improvement education

February 16, 2016:

With all the trials and tribulations that came with the ICD-10 transition, the work is far from over. A continual flow of new codes and more complex systems require organizations keep the gas pedal down on education and training.

Cue sighs of dismay from staff who’ve already sat through hours of instruction to prepare for the dive into ICD-10’s depth. “Training fatigue” is a real problem, as ICD-10 requires ongoing clinical documentation improvement (CDI) education. The challenge now is how to keep the attention of clinicians, as well as CDI specialists, in ongoing training.

The key is to focus on what’s ahead. CDI staff and others intimately involved in ICD-10 have seen the standard PowerPoint overviews ad nauseam. Now is the time to place training emphasis on the impacts of code shifts, and more importantly DRG shift patterns and percentages. Data about these shift patterns is sparse, but trainers can take proactive steps to maintain momentum and keep staff engaged.

How will you keep CDI education interesting?

Next-generation education starts with highlighting subtle documentation shifts that change a DRG. Coders know that a slight turn of phrase can change a code and DRG, which in turn alters the severity, relative weight, and expected length of stay associated with the DRG. Clinicians and CDI specialists often lack this depth of knowledge, so it’s critical to build ICD-10 education around these information gaps.

A good trainer knows that each individual learns in their unique way. One-size-fits-all educational documents may not work. There is value in taking time to see what standard literature sources staff likes using and then building those sources into ICD-10 training. There may be disagreement as to which sources are best or how to interpret the same information. Those conflicts are perfect segues to help clinicians and CDI specialists identify potential pitfalls in ICD-10 coding – and how to avoid them.

Above all, get all players involved in solving problems and identifying ways to keep ICD-10 education fresh and informative. Use real-world examples to highlight priority issues and to show how proper clinical documentation leads to higher quality and accurate revenue. Documentation from actual cases – with personal health information redacted – can draw clinicians and CDI specialists into discussions about how proper clinical documentation can lead to good outcomes for the patient. Personal experience far outweighs rote bullet points on a PowerPoint slide.

Finally, make all ICD-10 clinical documentation training participatory and interactive. Smaller groups will foster deeper discussions and problem-solving. Trainers also can use set-up questions based on a controversial topic (encephalopathy, malnutrition, functional quadriplegia, demand ischemia, renal failure, etc.) or Recovery Auditor target issues that may generate differing opinions.

Great education can lead to better performance

Maintaining engagement of clinicians and CDI specialists in ICD-10 education requires proactive, creative thinking. Providing new ICD-10 codes with general use guidelines is no longer enough. Health care organizations must continually cultivate ICD-10 resources for innovative ways to share information and engage staff in consistently clinical documentation improvements.


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