As I indicated in the first post of this series, the impact that ICD-10 implementation will have on coding productivity is dramatic, both because of coders unfamiliarity with the new ICD-10 code set and because of the inherent increase in complexity of the documentation and the thought processes to properly identify ICD-10 codes.

It is difficult to identify the extent of the productivity effects, but studies completed when Canada transitioned to ICD-10 (disease coding only) indicated a 50 percent drop in productivity that began to improve after three months, and settled at a permanent 20 percent drop after a year. More recent studies in the United States confirm 50 percent decreasing to 20 percent as a reasonable starting point for resource planning.

One of the biggest challenges the industry will face is that that every provider in the United States will be making the transition to ICD-10 on the same day and all will face the same coding productivity decrease. Clearly this is not a problem we can just throw bodies at – because they simply won’t exist.

What then can work?

As we discussed in the second post, the foundation for your plan to deal with productivity must begin with a strong training effort for your existing workforce. It won’t solve your productivity problem – all of the 50 percent decrease examples started with trained coders – but if your existing workforce isn’t able to begin coding to the expected throughput, all of the rest of your efforts to meet coding targets will still fall short.

Just because there will be a coding resource shortage is no reason to neglect recruitment and retention. In the third post we discussed appropriate strategies to retain your current workforce and position yourself as an attractive employer for new coders.

Many health care providers are turning outside the organization to coding outsourcing vendors. Although many of the organizations that are US based are reaching their projected capacity, there are many that utilize off-shore resources for a portion of their coding. Both types of companies can provide an alternative to full-time hires when properly managed, as we discussed in the fourth post.

Many facilities are evaluating the relatively new computer assisted coding (CAC) technology as a solution to meeting their coding productivity needs. As we discussed in our fifth post, CAC certainly presents a viable resource to improve coding accuracy and throughput, but hospitals that aren’t well along in the purchase and installation pipeline will probably not be able to deploy it by October 1.

Finally, as we discussed in the last post, consider revamping your coding workflow to eliminate non-coding work, ensuring your documenters are fully trained to provide coders with the information they need to code charts, and make sure that the coders have appropriate reference materials including the availability of a knowledgeable resource to answer their inevitable questions.

As knowledge leaders in ICD-10, Phoenix consultants deal with complex issues such as finding solutions to coding productivity issues with hospitals like yours every day.  If you have questions, or want to discuss how we can help you with your particular ICD-10 implementation challenges, call us or contact us through our website.