Assessing dual coding costs

Healthcare organizations will have to use both ICD-9 and ICD-10 for a considerable amount of time in 2014 in order to complete a successful transition to the new system.

Health IT vendors which support dual coding will be the ones who will stand out, although care providers may not be able to afford it.

Medical coders need to be trained for ICD-10 as well. However, they are not the only ones who require training. Physicians need to be trained on documenting correct ICD-10 code specificity. If this doesn’t happen, dual coding will not be beneficial in any way.time to plan

Dual coding is a way to test medical coders’ knowledge and documentation. However, the testing process must not be hampered by mistakes that could be addressed through awareness campaigns. Dual coding must be used to locate unforeseen problems which require time and money before it can begin.

Medical coding productivity is showing a 50% decrease in initial ICD-10 testing. This means that in the time required to process two test ICD-10 claims, coders should be able to process four real reimbursement claims. But it is not the case. Add to this the time spent to clarify queries from physicians and coders find themselves unable to prepare ICD-9 claims.

It really depends on a healthcare organization to do a cost-benefit analysis to see whether it needs extra medical coders to accommodate ICD-10 testing or is okay with longer reimbursement cycles. It is also important to realize that medical coders are not sure if they are using the right ICD-10 codes since the system is new for them as well.

The Hospital of the University of Pennsylvania has formed a team of 10 ICD-10 superusers to ensure coding accuracy. Each member uses the same records for coding and then all of them compare results with each other to discuss possible variances and the reasons for them. After the discussion, they reach a consensus on the correct ICD-10 codes required for the procedures and how they can unanimously agree to it.

But while it may sound great, it is adding more time and cost to the dual coding process. Compare this to the financial hit health organizations will have to take after October 1 if they are unprepared and it looks negligible.

It may be a good investment to allow medical coders to play with the ICD-10 system before the deadline to improve documentation. Care providers have real cases to test for ICD-10 through clearinghouses and payers and which will automatically tell them a lot about their HIT resources.

But once care providers have the much discussed ICD-10 data, what will they do with it? They can use it to add to internal medical research, assess financial impact, predict DRG shifts and reimbursements after the October 1, 2014 deadline.

Someone will have to invest time and resources in analyzing dual coding data. The Healthcare Information Management (HIM) department might be able to do that or consultants will be required for it. All of this time and money spent will be considered investments after October 1 but practices will not figure this out unless they start assessing dual coding costs right now.