Coding Productivity: Planning ICD-10 implementation is going to cause some pain

Carl Natale
by Carl Natale

You need to accept that ICD-10 will decrease your medical coding productivity sooner than you think.

This may be news to some hospitals.

According to Jim Jacobs, senior vice president and product management and health information management for QuadraMed, "People have not fully thought through, or they're still figuring out what the productivity impact is going to be and what that's going to mean financially."

For example, simply training staff means you're taking them away from work. According to Jacobs, there are providers that aren't budgeting or scheduling for that loss of time. And the process of planning will take staff away from daily duties. So this is going to hurt a bit before Oct. 1, 2013.

Jacobs is in a good position to see what hospitals are planning. QuadraMed provides technology and services to about 2,000 clients at healthcare provider facilities. Jacobs and his people are helping mid-size to large hospitals manage process, productivity and clinical outcomes. In other words, hospitals come to QuadraMed to relieve and manage the pain associated with initiatives such as ICD-10.

Coding productivity to drop after ICD-10 implementation also

While hospitals may not realize that productivity loss is a possibility while they are still using ICD-9 codes, they are thinking about what happens after the deadline. Jacobs says they're asking "Are we going to be able to get as much productivity from our teams as we formerly did as we go through this ICD-10 transition?"

You're not going to like his answer.

"Without new approaches or without education or without other types of solutions I would not expect the hospitals to have the same level of productivity on ICD-10 as with ICD-9," said Jacobs.

The learning curve will be a factor in the short term. But the complexity and specificity will be an ongoing problem. Those factors are going to highlight any documentation weakness. But Jacobs thinks there are ways to return to ICD-9 levels of efficiency.

"If you put in new processes, put in training , computer assisted coding, put in a CDI program ... We're seeing a lot of movement towards outsourced coding," said Jacobs. "Then the hospital on the financial side can certainly remain whole, we believe, as it relates to ICD-9 reimbursement."

"If you add the other solutions, you can expect a hospital to be as productive as they were."

Coming Wednesday

Jacobs talked about a few other concerns that healthcare providers need to keep in mind while planning ICD-10 implementation. Tune in Wednesday for more of Jacobs' advice.