July 24, 2012

It Takes a Village to Train a Village in ICD-10

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Currently, it is not uncommon for a hospital or healthcare system to have partial or total ownership of other healthcare entities (such as physician offices and skilled nursing facilities) – so the result is a village of healthcare providers who provide various services in either a single county or multiple counties throughout a state or region.

 

Depending on the organizational structure of these healthcare entities, there may or may not be a corporate health information management (HIM) coding manager. However, regardless of the organizational structure, just one HIM coding manager can have a major impact on the successful implementation of ICD-10-CM/PCS in all of the healthcare entities.

At least once a month, most, if not all, HIM coding supervisors and/or managers should conduct coding meetings with their staff. These coding meetings are used to address:

  • Coding errors identified by the patient financial services department during claims processing or submission;
  • Coding errors identified by internal or external auditors (compliance analysts, Recovery Audit Contractors, etc.)];
  • Complex coding issues unique to a facility or facilities;
  • Complex clinical conditions and surgical procedures;
  • New coding guidelines published by authoritative bodies (the ICD-9-CM cooperating parties, the American Medical Association, etc.); and
  • New regulatory requirements and the impact on coding (i.e. new modifiers).

HIM coding managers working in hospital or healthcare systems that own or operate numerous healthcare entities should strongly consider customizing the traditional monthly coding meeting model and using it to introduce ICD-10 to coding staffs in the other entities.

While the HIM coding manager may oversee the development and presentation of these monthly ICD-10 coding meetings, the coding manager also can enlist a “village” of interested ICD-10-trained coding professionals to assist with conducting the monthly meetings (these professionals can include coding specialists, RAC coordinators, clinical documentation improvement specialists, etc.).

An example of an ICD-10 monthly coding meeting model appears below:

  • Invite coding staff from a specific healthcare entity to attend each monthly ICD-10 coding meeting, such as
    • Outpatient clinics (September 2012)
    • Medical physician practices (October 2012)
    • Surgical physician practices (November 2012)
    • Inpatient rehabilitation facility (December 2012)
    • Inpatient psychiatric facility (January 2013)
    • Home health agency (February 2013)
    • Long-term care hospital (March 2013)
    • Skilled nursing facility (April 2013)
    • Complementary and alternative medicine (May 2013)
    • Urgent care centers (June 2013)
    • Diagnostic imaging centers (July 2013)
    • Hospice (August 2013)
    • Ambulatory surgery centers (September 2013).
  • Give staff from the healthcare entities the option of attending the meeting in person, via webinar or by videoconference (and work closely with the organization’s audiovisual team – the media “village”).
  • Limit the duration of each monthly meeting to a maximum of 90 minutes to increase the likelihood of staff participation.
  • Use the attached ICD-10-CM Quick Reference Guide and ICD-10-PCS Quick Reference Guide to present ICD-10 background and conventions in a timely manner. Print each guide on the front and back of a sheet of paper so participants will have no more than two sheets of paper as their handouts.

Click to download the zip file containing the ICD-10 CM Quick Reference Guide and the ICD-10 PCS Quick Reference Guide [56KB]

  • Investigate securing continuing education (CE) credits from the organizations that accredit coding professionals (i.e. the American Health Information Management Association). Post the CE certificates on the organization’s Intranet for easy retrieval by those individuals who attended the meetings. Require each participant to complete a brief online evaluation of the coding meeting before the CE certificate can be downloaded or printed via the organization’s Intranet.
  • Develop a formal process to review the completed evaluations and use the feedback from participants to structure extensive ICD-10 training for all of the healthcare entities in late 2013 and/or 2014.

Whether you use a model similar to the one described here or develop your own model, remember to enjoy the journey to ICD-10 compliance, and take as many villagers as you can along with you for the exciting and challenging ride!

Lolita M. Jones, RHIA, CCS

Lolita M. Jones, RHIA, CCS, is the principal of Lolita M. Jones Consulting Services (LMJCS), founded in October 1998 in Fort Washington, MD. Ms. Jones has over 25 years of experience in coding and consulting. She started preparing for the implementation of ICD-10-CM/PCS by going back to school. On September 12, 2010, Ms. Jones became an AHIMA-approved ICD-10-CM/PCS trainer.