Survive & Thrive After ICD-10

ICD-10 mirrors Y2K; speculation and anxiety surrounding new changes and the unknown. Just like Y2K, we all survived without catastrophic meltdown.

There was substantial fear surrounding what ICD-10 would bring: extreme coding changes, payer denials, inflated DNFBs, coding backlogs, etc.  As the ICD-10 coding freeze thawed, fear dissipated as industry-wide coders stepped-up to the challenge. Aided by the tenets of their profession, coders learned ICD-10, mastered the new guidelines, and became proficient.

New guidelines are still having a dramatic impact on the coding world and continue to present challenges. For example, ICD-10 PCS coding, which is only for inpatient procedures, is a trouble spot for many inpatient coders.

ICD-10 PCS coding:

  •  coders must choose the correct root operation from 31 possible choices, and
  •  select the appropriate characters from the PCS tables to “build” the procedure code

This process is not always easy, but inpatient coders are still hitting ICD-9 production metrics.

Post ICD-10 trends are showing positive results for hospitals and physician practices who rely heavily on coders to keep their unbilled in check.

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There is still a demand for coding support to achieve optimal ICD-10 coding, reimbursement,  and compliance for facilities:

  • continuing education on new changes and challenges 
  •  identifying trends in inadequate documentation
  •  proactive denials management
  •  hands-on coding management
  •  monitoring work queues and unbilled reports
  •  robust auditing and reporting
  • shifting coders to maintain dynamic workflow

The team at HRG has noticed great success from implementation and mastery of these practices. Most recently, we saw powerful benefits of successful managerial oversight by cutting client’s billable coding needs while still providing high-quality results.

Coding quality is as important, if not more so, post-ICD-10. A stringent auditing program can ensure coders are reaching the highest quality coding possible. HRG helps our coders continually surpass industry standards by employing a model involving 100% review of new coders, or when a coder is new to a client, or new to a service line. They are closely monitored from the beginning of the new assignment and then through ongoing audits.

As tempting as it is to sit back and relax now that initial ICD-10 fears have subsided, there is still a real need for ongoing improvement. Industry changes are not slowing and neither should commitment to coding quality and compliance.

Hopefully these helpful tips resonate with your experience in ICD-10. Please reach out if you have questions or need coding support. HRG has always provided exceptional service to its HIM clients. We are here to help.

About the Author

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Kelly Jacobus


DIRECTOR OF FACILITY CODING FOR HEALTHCARE RESOURCE GROUP, INC. 

Kelly Jacobus, CCS, CDIP, CHDA, CCS-P, CPC, has just under twenty years of experience in facility and professional fee coding and AHIMA Approved ICD-10-CM/PCS Trainer. Kelly also has experience in academic medicine and shares her passion for healthcare excellence with her team of dedicated, coding professionals at HRG where she is the Director of Facility Coding.

 

 

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