Now that the time of ICD-10-CM/PCS has finally arrived, there will be challenges ahead on how to keep coders engaged after years of preparation and training. During the Monday presentation “ICD-10: What are you going to do tomorrow?” Rick Szymborski, RHIA, and Kristin Johnson, RHIA, from Anthelio Healthcare Solutions, shared strategies and methods for coder engagement, how to increase efforts to help HIM professionals stay on course, and the use of metrics to track and validate a successful transition.
According to Szymborski and Johnson, focusing on coder morale is key to keeping coders engaged—you should communicate often with your coders and make an effort to keep morale high. Even if you already have great communication with your coders, this is the time to amp that up, they said. The ICD-10 transition is a monumental change for coding professionals, as well as others in the healthcare industry.
They may need this time to express their feelings about the difficulties and changes they are experiencing. To instill confidence in their efforts, Szymborski and Johnson recommend giving the coders credit for getting to this point. Appreciate and applaud the coders’ ICD-10 preparation efforts and their journey to get this far. Make sure to keep in mind that it is not only a huge coding change for them, but there is also the increased scrutiny with regulatory oversight of coding (i.e., RAC, CDI).
Szymborski also reminded the audience to listen to the coders in the initial weeks and months; they will be the best resource for improving the process going forward since they are working with ICD-10 codes on a daily basis. It is important to provide them every opportunity to solve problems and take constructive action. Keep them engaged by increasing communication and include coders in the problem-solving process so they know what is going on each step of the way and don’t feel left out. A disengaged coder is the last thing any healthcare organization needs at this crucial time.
Szymborski discussed the key area of coder productivity. It will be extremely important to monitor coder productivity closely—even daily—at first. Coders take pride in the quality of their work as well as productivity, and they will want to continue to excel in these areas with the implementation of the ICD-10-CM/PCS code sets.
Constant communication on quality and productivity allows coders to receive assistance immediately if needed. Szymborski stressed that there needs to be an avenue for open dialogue that is supportive. It’s a good idea to not penalize coders initially for a drop in productivity, as this will not foster improvement during the transition period. Remember—this is new to them and there will be an adjustment period to work through. Give them time as well as support. Make it safe for them to express any issues they are experiencing. Szymborski suggested managers track and trend how the coders are progressing, as that information can be used to create reasonable productivity standards.
Szymborski and Johnson shared some detailed tips to assist with productivity. These included:
- Secure additional coding support in these initial coming months—and likely beyond
- Ensure whoever supports you has proven quality and turnaround to support timely discharge not final coded (DNFC) and minimize the impact on accounts receivable
- Validate that support staff have the capability to provide service with minimal oversight
- Check quality scores, such as KLAS, to ensure your support doesn’t end up taking you away from supporting your own coders
Metrics will be another key area to follow. The presenters reminded the audience that HIM professionals play a key role. “If you can’t measure it, you can’t manage it,” Johnson stated. Even though HIM professionals may already be capturing metrics, Johnson said they’ll need to watch them more closely than ever. She stressed that identifying any issue, even a small one, is key and that all issues should be addressed immediately.
The presenters also suggested to monitor financial exposure metrics, including:
- Increase in dollars and accounts in DNFC and DNFB
- Increase in rejection/denial rates
- Delays in claim turnaround time by payers
- Increase in claim PEND rates
- Change in case mix index
Borrowing a line from Mark Twain, Johnson ended the presentation on a high note, reminding the audience: “The secret of getting ahead is getting started.”