With the initial shock of the latest ICD-10 delay behind us, now is the time to leverage it as opportunity to ensure that coders are fully prepared for the transition. Coder training and readiness is a critical element of ICD-10 success. The additional time will give coders the ability to apply their skills through practice and become proficient in ICD-10. Consider the following tips to keep training and education on track:
Tip No. 1: Build practice time into coders’ schedules.
Coding real cases is very different than learning from books. Give coders actual medical records to code using ICD-10. Implement a robust dual or double-coding program. This will identify where coders are struggling and give them an opportunity to make mistakes before it counts.
Furthermore, if you provide coders with practice opportunities, you must have a mechanism in place for them to provide timely feedback. Check coders’ work thoroughly until you reach a level of quality deemed acceptable for your organization.
Also, create an environment in which coders can discuss difficult cases and create organizational guidelines in lieu of official coding guidelines. Most organizations are planning for a 50 percent decrease in coder productivity, so by leveraging the delay, you can decrease productivity impacts at implementation.
Tip No. 2: Move beyond the basics.
ICD-10 training is a necessity; however, refining skills in certain specialties is a luxury that coders might not have otherwise had the 2014 deadline had remained in place. Use the ICD-10 delay as an opportunity to provide focused education for coders on the most problematic areas.
- Assuming coders have received basic ICD-10 training, focus on the difficult service lines specific to your organization.
- Identify and create meaningful, focused specialty training.
- Perform individual ICD-10 coder assessments to gauge coder skill level while identifying areas for additional training.
Tip No. 3: Build internal expertise.
Use the delay to elevate internal coding experts’ confidence and knowledge of ICD-10. Identifying one or more internal ICD-10 coding expert supplies staff coders with a quick and reliable resource; plus it assists with coding reviews, quality monitoring, audit responses, and building of coding consistency. Utilizing internal resources decreases dependency on external ICD-10 experts.
Tip No. 4: Revisit training timelines.
Almost everyone within your organization will require some type of ICD-10 training. Although coder training should not be delayed or minimized in any way, organizations may want to delay non-coder training.
For example, ICD-10 training for pre-authorization staff, billing staff and case management may be more effective if performed closer to the actual implementation date. Alternatively, it may be helpful to provide training for informatics and data management staff more immediately.
Identify all individuals who require training and determine whether you will delay each type of training based on how those individuals will use ICD-10 and what role they will play in its implementation.
Tip No. 5: Revise training budgets.
Organizations weren’t planning for an ICD-10 delay, which means that 2015 budgets may be impacted. When revising the coder training budget, ask the following questions:
- Can you re-allocate funds for 2015? Consider re-allocating money that would have been spent on contract staff to offset productivity declines throughout the year. Use this money instead to provide more targeted coder education and refresher training.
- When and how will you provide additional training? Identify the type and cost of training and the number of staff impacted. Consider budget dollars to address non-productive time during training. Are there new staffers who will require basic training? Is there a cost to assess current coder skill level?
- Are there alternative ways to provide training? Reach out to physicians to provide brief educational sessions to coders about certain procedures and the equipment used to perform those procedures. This helps coders understand the procedures when applying the ICD-10-PCS codes. Create a coding roundtable through which coders can collectively code a record and share ideas and feedback. This is an excellent forum for coders, who can learn from one another and capitalize on internal knowledge.
- How will you retain coding staff? Although this isn’t directly related to coder training, organizations need to consider strategies for retaining trained and qualified coders. Consider costs for establishing or extending retention bonuses.
We have at least one more year to prepare for ICD-10. Don’t waste the additional time. Use it to your advantage.
About the Author
Mary Beth Haugen is the founder and CEO of Haugen Consulting Group. She has more than 25 years of experience in the healthcare industry. Mary Beth is currently on the American Health Information Management Association (AHIMA) Foundation Board and formerly served on AHIMA’s EHR Practice Council. She is also a previous member of the AHIMA Board of Directors. She serves on the Regis University HIM Program Advisory Board and is a nationally known speaker on topics such as ICD-10, the legal health record, integration of healthcare technology, e-discovery, managing electronic health records, managing IT projects, and leadership.
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