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A Look at HIM and the Impact of ICD-10 – HIM Scene

Posted on July 6, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the HIM Series of blog posts. If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

After all of the noise that was made around the move to ICD-10, I’m now talking to more and more people about what impact the switch to ICD-10 has had on their organizations.  The reality for many organizations is they don’t really know what the new normal is under ICD-10.  So, they’ve had a hard time evaluating if their ICD-10 work has been going well or not.

With this in mind, I was excited to talk with Eileen Dano Tkacik, Director of Operations & Information Technology at AVIANCE Suite Inc, about a survey they did that looked at ICD-10 accuracy and productivity.  Learn more about the results of this survey in the video below and review the full survey results. Also, check out their 2017 ICD-10 coding contest which includes $5000 in prizes and begins July 17, 2017.

Eileen is so right that the transition to ICD-10 definitely sucked up people’s time and the QA process suffered. I hope now that ICD-10 has been around for almost 2 years that more efforts will go back to QA. We’re going to need to given the ICD-10 accuracy results from their survey.

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

ICD-10 Check-Up

Posted on May 13, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

It’s hard to believe it has been seven months since we implemented ICD-10 in the US. We talked about this subject and planned for so many years and now it feels like second nature. Looking back, I would label the implementation mostly successful and smooth. Would you say the same?

If you’re like me, you have forgotten some or most ICD-9 codes and have a nice repertoire of ICD-10 diagnosis codes swimming around in your head daily. At least memorizing the beginning of a code is helpful when you only need to search the encoder for the fourth through seventh digits of the code to further specify laterality and detail.

Conducting an external audit on ICD-10 coded accounts at this point is a good idea to make sure coders are accurate with the new code set. It’s important to watch for any trends in DRG shifts that may be attributable to ICD-10. If claims data for the past seven months have not been reconciled with expected reimbursement, now is a good time to be reviewing for coding and billing accuracy.

We were promised more specificity with ICD-10 and I believe we have somewhat achieved that. There are still opportunities to improve physician documentation and gather more detail in order to assign the correct codes. For the most part, I believe physicians have been affected by HIM teams bringing awareness to specific documentation and education on what is needed for ICD-10 coding and billing. ICD-10 has not turned out to be the burden that everyone was initially so reluctant to; at least from my experience.

In the blog post I wrote soon after ICD-10 implementation, I mentioned that coder productivity was a big issue to watch for with ICD-10. With sophisticated coding tools, thorough training, and skilled coders, the productivity impact has been real but not nearly to the extent some HIM managers were bracing for. We are starting to see coder productivity come to a manageable level that will probably be the norm for the foreseeable future.

I’m happy to report that I feel confident in ICD-10 as our designated code set and based on peer input, I think others will agree. The specificity was much needed after many years of vague or catch-all codes. This paves the way for better data reporting and thus more quality information resulting in better disease management. Accurate reimbursement is an obvious bonus as well.

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

A Study on the Impact of ICD-10 on Coding and Revenue Cycle

Posted on January 27, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

Implementing ICD-10 coding has been, in some ways, like learning a new language. We took a specialized task that has been repeatedly performed for over 30 years and turned it on its head with new guidelines, new characters, and new specificity that we have never had before. Many healthcare leaders have been watching for (and possibly expecting) catastrophic effects of the changes to surface after the implementation of ICD-10 such as a reduction in reimbursement and an increase in denials. A recent study commissioned by Primeau Consulting Group surveyed respondents to see how healthcare organizations are doing with ICD-10 and how they are preventing denials.

It’s no surprise that ICD-10 has led to a decrease in coder productivity. In fact, the survey showed that 66% of those surveyed had experienced some negative changes in coder productivity. Some respondents claim somewhere between a 25% to 35% decrease in productivity. I know all HIM leaders want to know if this will be a permanent or temporary loss in productivity and that is yet to be determined. When equating this productivity loss to A/R days, this can have a huge impact on the number of accounts in an unbilled status waiting for coding. Unfortunately, 34% of respondents to the survey have already seen negative impacts on the revenue cycle since ICD-10 was introduced.

In preparation for ICD-10, it was difficult to predict if additional training and education would be needed after the ICD-10 go-live. Some feedback in the survey showed that respondents did not necessarily plan for additional formal ICD-10 training for coders in 2016 but will keep up with the standard continuing education that has always been part of a coder’s job. I think this is still yet to be determined pending the results of coding audits that will show areas for education and documentation improvement.

While ICD-10 has been relatively smooth thus far, HIM leaders are still proceeding with caution and bracing for any potential downsteam impacts that could result from the drastic changes we have undergone. The study revealed that the most commonly perceived risks with ICD-10 in 2016 center on physician documentation and specificity. Again, I believe auditing will be key in determining education for coders as well as physicians.

How has the ICD-10 experience been for you? Are you seeing similar issues or risks?

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

How Can Organizations Leverage the Increased Specificity of ICD-10 Codes?

Posted on October 30, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Edifecs did a survey of more than 450 healthcare industry representatives to find out how they plan to use the increased specificity of ICD-10 codes. Here are the results of their survey:
ICD10CodedData-01

What do you think of these areas of ICD-10 benefit? How does your organization plan to benefit from ICD-10 coding?