AHIMA: As Coding Evolves, So Must We

Original story posted on: February 4, 2019

A new white paper from the industry bellwether looks back, forward in framing big picture of coding.

Benchmarking, the term that encompasses performance measurement in the healthcare industry, will be key for providers seeking to refine their efforts to master ICD-10 as ICD-11 implementation looms in the distance, according to a new white paper published by the American Health Information Management Association (AHIMA).

“With ICD-10-CM/PCS fully in place, from the healthcare industry’s perspective, leaders in health information management (HIM) departments continue to assess its success and functionality,” the Association said in a press release announcing the white paper’s publication. “As the industry looks ahead to where coding productivity will go next, HIM leaders must measure its progress, as coding plays a huge role in controlling costs, structuring risk management, (and) ensuring quality care, among other issues, in the broader healthcare landscape.”

AHIMA’s white paper, titled Measuring and Benchmarking Coding Productivity: A Decade of AHIMA Leadership, outlines the Association’s review of how coding has evolved – “beginning with ICD-9-CM, the transition to ICD-10, and looking ahead to what the healthcare industry can expect next in coding and documentation.”

“By leading the transition from ICD-9 to ICD-10, AHIMA and our members saw the growing demand for high-quality data to support patient safety and reduce healthcare costs and continue to develop best practices to meet the demand,” AHIMA CEO Wylecia Wiggs Harris said. “Benchmarking where we’ve been against where we are now allows us to look at how coding affects the various sectors of the healthcare industry, and ultimately lets us pave the way for the future of coding productivity.” 

AHIMA’s white paper lays out a timeline of ICD-10 implementation, noting that a key first step was evaluating the productivity of ICD-9 to create a benchmark for the 10th edition of the International Statistical Classification of Diseases and Related Health Problems. The Association said the following attributes proved to rank among the most critical when it came to increasing the likelihood of achieving optimal coding productivity:

  • High-quality, consistently available, high-speed, and secure network access to needed data sources and repositories
  • Ease of access to data, as well as the availability of that data in a single source, i.e., the electronic health record (EHR), versus data that must be accessed from multiple sources
  • Data presented in a narrative structure versus documentation segregated by clinician or data type
  • Timely transcription of, completion of, and access to necessary documentation, written orders, results, and reports
  • Online/mobile access to relevant, timely coding materials, edit guidance, and an encoder coupled with reference material
  • Access to at least quarterly coding-oriented professional development

Full implementation of ICD-10 took place in October 2015 – four years after the initial federal target goal of October 2011. But in the three years and change since, AHIMA touted what it labeled several of its landmark achievements in gauging the healthcare industry’s progress:

  • An ICD-10 study examining average inpatient coding times from more than 150,000 medical records in a five-month period beginning in October 2015, showing an initial dip in coding productivity immediately following the transition and increasing gradually in the weeks following;
  • A study evaluating more than 165,000 patient records beginning in March 2016, further noting an increase in coding productivity over a five-month span; and
  • A survey to gather insights via phone from 156 HIM professionals, finding that approximately 74 percent indicated a change in productivity, with 31 percent noting an increase.

AHIMA, which represents over 100,000 HIM professionals worldwide, pledged in its press release to continue to “conduct research to address numerous points of coding productivity in various settings, such as outpatient, emergency room, home care, long-term/post-acute care and more. The organization will also look at characteristics of the coder such as education, experience, incentives and credentials, in order to ensure success for the HIM profession.”

“With ICD-11 on the horizon, AHIMA is prepared to lead the way through ongoing research related to current and future versions of ICD and how they can help improve coding productivity, accuracy and quality,” Harris said. “In this way, accurately benchmarking coding productivity helps contribute to the long-term sustainability of the greater healthcare landscape.”

For more information about the Association and its various initiatives, go online to www.ahima.org.

Program Note:

Listen to AHIMA’s Julie Dooling report this story live today on Talk Ten Tuesday, 10 a.m. EST.

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Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.
Mark Spivey

Mark Spivey is a national correspondent for ICDmonitor.com who has been writing on numerous topics facing the nation’s healthcare system (and federal oversight of it) for five years.

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