ICD-10-CM/PCS Coder Training. Success Strategy

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ICD-10-CM/PCS Coder Training

Success Strategy

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UASI – United Audit Systems, Inc.

UASI Training Strategies Cincinnati, Ohio

Introduction

Most would agree the transition from ICD-9 to ICD-10 brings about significant differences in the code sets. Robust training is not only necessary but critical to prevent productivity loss and maintain accuracy and coding compliance. There is substantial evidence, based on thoughtful research, supporting why training is important and how it provides return on investment.

Training Elements

Creating a strategy with timely execution is key.

 Plan it How will it be done?

 Map it What will you need?

 Do it Who will do it?

 Assess it What follow up will be necessary?

For most the school years are in the distant past. Adult learners learn differently. Going back to the basics with a 1 – 2 – 3 phased approach provides adult learners in training with a roadmap to learning success.

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Phase 1: Get Ready Get Prepped

A thorough review of Anatomy and Physiology should be completed in Phase 1. This preparation is key to moving efficiently through Phases 2 and 3.

Phase 1: Preparation to Use ICD-10-CM/PCS

 Timeline: throughout 2013 (complete by 1/1/2014)

 Training objective is to refresh knowledge of biomedical sciences to ensure success in navigating the ICD-10-CM/PCS systems.

 Instructional Methodology: Online training or audio CDs on medical terminology and Anatomy and physiology by body system.

 Training Plan: Complete assigned training every Friday in the Computer lab.

Phase 2: ICD-10-CM/PCS Fundamentals  Timeline: January – July 2014

 Training objective is an introduction to ICD-10-CM and/or ICD-10-PCS followed by systematic progression through the entire coding systems (chapter by chapter) to understand the code structure and coding conventions. This phase will also include an introduction to ICD-10-CM and/or ICD-10-PCS guidelines.

 Instructional Methodologies: Online courses, onsite workshop, assessment tool.

Phase 3: Application of ICD-10-CM/PCS  Timeline: July - September 2014

 Training objective is to gain proficiency in assigning ICD-10-CM and/or ICD-10-PCS codes and reinforce and apply concepts already learned in Phases 1&2. Includes additional focus on reinforcing ICD-10-PCS concepts (such as root operations).

 Instructional Methodology: multi-media approach to provide opportunities to practice coding case scenarios.

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Phase 2: Deep Dive

 Coders will need a complete introduction to the code sets.

 Provide a thorough review of each section chapter by chapter of the code sets and guidelines. Include coding examples for application based learning to reinforce coding concepts. Dive deep.

 Organize training sequentially to purposefully build on earlier learning for maximum retention.

 Discuss major changes from ICD-9-CM to ICD-10-CM in structure, terminology, codes that moved out of previous categories.

Learning Objective

Content Applicable Staff Learning Time Schedule

ICD-10-CM Overview ICD-10-CM structure, conventions, guidelines HIM coders, CDS, & Physician coders 2 hours January 2014 Detailed ICD-10-CM training Systematically review ICD-10-CM Chapters 1-21 HIM coders, CDS, & Physician coders

15 hours January - Feb 2014 ICD-10-CM Assessment Assessment of competencies to date HIM coders, CDS, & Physician coders 2 hours By March 1, 2014 ICD-10-PCS Overview ICD-10-PCS structure, conventions, guidelines HIM coders, CDS, (not physician coders) 3 hours March 2014 Detailed ICD-10-PCS training

Med Surg section root operations and approaches; all other sections

HIM coders, CDS, (not physician

coders)

40 hours March – June 2014 Review and Assessment of ICD-10-CM/PCS learning Comprehensive assessment of competency

HIM coders & CDS 4 hrs, physician

coders 2 hrs

2 to 4 hrs By July 15, 2014

Total Hours for Phase 2: HIM coders, CDS 66 Total Hours for Phase 2: Physician coders 21

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Phase 3: Practice Makes Perfect

 Now that coders have completed a thorough review of the code sets and coding guidelines, it is time to practice using your own case mix. Extensive practice using cases the coders are familiar with to gain proficiency as well as confidence will in turn reduce the chance of coder “perfection paralysis.”

 Coders know ICD-9-CM. However, ICD-10-CM/PCS is all new. Because coders want to get it right, they may have the tendency to spend too much time researching and polling other coders’ opinions rather than putting it into practice. In the end the research and polling could result in information that is simply unimportant.

 One of the goals of practicing the new code sets is to look at the most applicable codes rather than the least likely scenarios.

 Select practice cases from each specialty or each unit/floor of the hospital to systematically address the most common cases your coders need to experience. Master each area before moving on to the next.

 Use this time to also ensure no coder is left behind. Provide additional training on any critical concepts coders might be struggling with.

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Things to Consider

The Unbilled – Assess productivity impact of training on workflow. If training impacts the unbilled,

the unbilled will impact training. With any training strategy you may want to consider how you will address workflow interruption while in training. Should you plan for overtime, limit PTO or hire outsourced help to cover? Above all budget for the unbilled.

The Debrief – It is not enough to merely provide access to online training. Make sure your coders

are moving through training successfully. Don’t let them struggle alone to understand written training materials. Don’t let them get frustrated. Answer questions quickly. Track success rates to address difficulties proactively. Above all respond and support the coder.

The Assessment – You trained, they practiced now you need to assess what the coders learned.

Taking your student population into consideration, decide if assessments and evaluations are pass/fail or a graded system with a minimum bar. Will your students benefit from testing after each chapter, at the end of training or a combined approach? How will you handle those who fail or test subpar? Also consider how to handle new hires who arrive mid or post training. Above all leave no coder behind.

The Resources – Take stock of your current reference materials and determine what additional

resources you will need for training and for the coders to use during training. Above all budget for additional reference materials.

The Exit – Most HIM departments experience some attrition. With coders in high demand and

short supply, planning for turnover will result in better preparedness. Create a plan in conjunction with your HR department to account for orientation hours which could include ICD-10 training, adjust productivity during the attrition time period. Above all budget for turnover.

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Leading Practices

Start with ICD-10-CM. Master it then move to ICD-10-PCS. Coders need to code in order to learn the new codes sets. Using coding examples that include the entire health record will make learning more than just theory. Whether a facility chooses “out of the box” training or a customized approach, make it a best practice to supplement materials with the facility’s own cases.

ICD-10 Students are adults. Adult learning strategies vary. It is wise to assess the student population to determine which adult learning strategy will be most effective.

Visual Learners – need to see it in action.

Active Learners – need to hold it, touch it or practice it. Auditory Learners – need to hear it.

A mixed approach with a blended student population offering a combination of lecture, case studies, and group activities will ensure success for all, regardless of preferred learning styles. Instructors should provide material students can relate to (i.e. relevant to the hospital’s case mix). Otherwise if the material presented is information they would forgo, they will most likely forget it. Above all the learning strategy should motivate and engage students.

Training Timeline

It is estimated hospital coders will need 70+ hours of training. Physician coders will need 25-35 hours. Determine timeframes that work best for the hospital and students – concentrated training (two week courses) versus spreading training over a few months. A slower pace spreads the three phases over several months but will require review of earlier concepts. The slower approach allows for post training assessments and time for remedial work for individuals struggling with the content. There are Pros and Cons to both. Choose the method that will work best for your student population.

Conclusion

Overall success requires thorough planning and execution. It is important to allow sufficient time for training as well as application. Practice. Practice. Practice. Hospital should expect significant return on investment from a robust training program.

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About the Company

UASI is a leading national provider of revenue cycle solutions designed to help

healthcare facilities achieve correct reimbursement in the quickest possible time.

Our services include: Remote Coding, Onsite Coding, Clinical Documentation

Support, Coding Compliance Audits, ICD-10 Support Services, Revenue Integrity

Audits, and Health Information Interim Management solutions. Based in

Cincinnati, Ohio with service nationally, UASI is unique in its ability to fuse

technology and professional services to deliver superior financial performance.

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UASI ICD-10 Support Services

Documentation Gap Analysis

Through an intensive medical record review, UASI provides an action plan to identify and correct documentation gaps and/or provide specific areas of focus for your Clinical Documentation Improvement (CDI) program.

Reimbursement Impact Analysis

To minimize financial impact, UASI coding professionals evaluate potential shifts and changes in the case mix index by comparing MS-DRG assignments based on 9-CM codes to those based on ICD-10-CM/PCS codes in a representative sampling of inpatient cases. Results are analyzed to identify variances and provide well-supported financial projections for transitioning to ICD-10-CM/PCS. Targeted Training on Documentation Gaps

Customized Training to Address Identified Documentation Gaps for Clinicians, Clinical Documentation Specialists and Health Information Management Professionals.

Targeted Application-based ICD-10 Training Support

Complete CM/PCS coder training onsite or remote including practice coding in ICD-10-CM/PCS for Medical Coding Professionals.

Coding Workforce Solutions

Experienced Coders available for supplemental coding. With proven experience in high volume, high quality coding, UASI is uniquely positioned to provide workforce solutions tailored to your organization – ranging on-site and remote coding staff augmentation to complete coding outsourcing.

ICD-10 Coding Accuracy Reviews

Action Plans for Improved Medical Coder Accuracy Rates.

For more information or questions related to ICD-10 Training, UASI’s ICD-10 Support Services and Post Go-Live Coding & Audit Solutions, contact us:

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