ICD-10 takes center stage at AHIMA 2012. Dr. Dianne Haas, Consulting Services Director at Trust HCS outlines 5 key takeaways from AHIMA 2012
Over 4,000 health information management (HIM) professionals gathered in Chicago earlier this month for their annual conference. And with only two years until ICD-10 go-live, implementation of the new code set took center stage. TrustHCS’s team of HIM experts attended the conference and each reported back on the good, bad and reality of ICD-10 .Here are five key messages we heard in educational sessions, exhibit halls and hotel lobbies. They are important take-a-ways for all healthcare provider organizations…including yours!
Ongoing Assessment is Critical
ICD-10 impacts the entire organization, both clinical and business operations. Whether it’s application vendors or clinical coders, ongoing and repeated assessment of ICD-10 readiness is critical. Keynote speakers and education session leaders reiterated this mantra while exhibit hall attendees were often heard asking each other, “so have you started your readiness assessments?”
Assessment is not a once-and-done. It must be repeated continually throughout the next two years and incorporate all aspects of ICD-10. Every application, management report, or departmental workflow that uses ICD-9 codes should be assessed. ICD-10 has hundreds of moving parts.
ICD-10 is A Whole New Language
ICD-10 brings a new “normal” to the words, phrases and lexicons used by healthcare providers every day according to Alice Zentner, RHIA, Director of Auditing and Education at TrustHCS. The new language will penetrate every nook and cranny of the EHR, clinical documentation, coding and billing. IT professionals take note! EHR templates will need to be updated for ICD-10 to accommodate its new terminology. Template editing alone could take two years! Start now.
Coder Roles…They Are a Changin’
Attendees also debated the changing roles of clinical coders and shared their insights with Clark Chaffin, MBA, RHIA, CCS and Director of Hospital Coding Operations for TrustHCS. Coders need to think more like auditors once ICD-10 is implemented. They will be asked to consider all the possibilities alongside all the missing pieces of clinical documentation.
To prepare for these changes, organizations can encourage coders to become more aware of charge masters, revenue codes, modifiers and UBs. And then educate them on how all the puzzle pieces come together under ICD-10. Working in a silo will no longer be possible. Coders have much opportunity under ICD-10, and now is the time to take advantage of it! Coder education must be comprehensive, incorporating much more than just the new ICD-10 codes.
CAC Won’t Fix Everything
Yes, coder productivity will drop under ICD-10. And it will remain low for many months. At AHIMA, many HIM Directors were evaluating computer-assisted-coding (CAC) applications with the hopes of using this technology to offset productivity losses. While computer assisted coding (CAC) certainly streamlines the coding process and boosts coder productivity, it is not a magic bullet.
For example, CAC systems perform well only when complete, accurate and terminology-rich documentation is fed into them. CAC technology can only “code” what is provided. It will never remedy poor clinical documentation. Secondly, electronic documents are essential since CAC systems can’t read scanned or handwritten text. And finally, CAC systems will never replace the knowledge of a coder and how a coder has been trained to find key details that are often hidden within the documents they are reviewing.
CAC systems may help you cross the chasm of ICD-10, but they can’t be your only bridge!
CDI is the Secret Sauce
ICD-10 requires specificity by clinicians in their documentation. This fact reinforces the need for hospitals to initiate or strengthen their CDI programs now, versus waiting until 2014 according to Evelyn Maggard, RHIA, Auditor and I-10 Educator for TrustHCS. Programs should be staffed with professionals whose only focus is CDI. These are full-time positions that involve chart auditing, knowledge of ICD-10 coding rules and DRG reimbursement.
To support effective CDI, communication and education with medical staff must be effective and ongoing. New relationships may need to be formed and new incentive programs put into place. Hospital administration must be 100% behind and in-support of your CDI initiative. Their role should include monitoring program outcomes and intervening when needed for medical staff full cooperation.
Don’t walk….run! Get started now. Garner executive support and take small, incremental steps to change physician documentation behavior well in advance of 2014.
AHIMA attendees were positive and focused this year. Marching order were clear and HIM professionals rose to the occasion. The next several years will bring a “new normal” to healthcare and the benefits of change will far outweigh the negatives.