Protect your Practice’s Bottom Line While Adopting ICD -10

by | Published on Jan 3, 2014 | Medical Coding

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It is true that ICD – 10 transition can improve the healthcare documentation process and benefit physician practices, patients, and the broader healthcare system by providing a better understanding of diseases and cost with improved clinical specificity. However, it is reported that many countries witnessed a sudden drop in coder productivity following the ICD – 10 implementation. Canada, for instance, witnessed approximately a 40 percent decrease in coder productivity in the initial stage, with long – term productivity losses pegged at 20 percent. Productivity never returned to the ICD – 9 medical coding levels.

Health Information Management (HIM) leaders are expecting a 20 to 40 percent decrease in coder productivity when ICD – 10 comes into use in the United States on October 1, 2014. It is important for healthcare practices to be prepared for this with proper measures, failing which they will be faced with delayed cash flow or lost revenue. The following measures can help in protecting your bottom line while implementing ICD – 10.

  • Education and Training for Coders – Medical coders need to be educated on ICD – 10 education and provided with the necessary training.  Once they start using the codes, it would be possible to measure the effects on productivity. According to American Health Information Management Association (AHIMA), around 50 hours of training would be necessary for coders to use the new code set efficiently. The training methods available are translation software, double – coding, dual – coding and platform – based education programs. Though translation software helps coders in identifying the codes quickly, it will not help them understand the appropriate use of each code, which is critical for regulatory compliance and reimbursement. The methods of double – coding and dual – coding can help in automatic code mapping and assignment. However, both cannot offer real – time educational feedback to enable compliance or the benchmark data needed to measure coder productivity and its effects on reimbursement. On the other hand, platform – based education programs can identify the problematic areas in real time and measure productivity so that the coders can be provided with additional training if necessary.
  • Measure Coder Productivity – Health care organizations can prevent medical billing backlogs and take proactive measures to protect their cash flow only if they measure coder productivity accurately. Suppose an organization has 8 coders and generates $8 million per day – $1 million by each. If the productivity loss is 30 percent with ICD – 10 implementation, the organization can generate only $5.6 million – with a $2.4 million backlog each day. After five days, the organization will have a $12 million backlog, which will seriously affect revenue flow, and in turn, the ability to meet its overheads.It is necessary to collect and quantify data from coders as they actually apply ICD – 10 codes to patient charts in order to measure productivity and accuracy. Platform – based training programs can meet these objectives.
  • Enhance the Coding Team – Once an organization measures and projects coder productivity and understands shortfalls, they should use the information to find resources to meet their needs. Whether you choose medical coding outsourcing or recruit permanent or temporary staffs, make sure that this can efficiently address coding productivity losses. Hiring permanent staff can help overcome long-term productivity losses while hiring contracted staff can address the temporary increase.

Claims denials can increase as payers adjust their reimbursement policies to include ICD – 10 codes in 2014.  It is important that you educate your staff on how clinical documentation and coding and billing will affect your reimbursement. With professional medical billing and coding services , you wouldn’t have to worry about such issues at all. An established medical coding company would have an experienced team of AAPC – certified coders that are ICD – 10 ready.

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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