Why coding audits are features not ICD-10 glitches

Carl Natale
by Carl Natale
Why coding audits are features not ICD-10 glitches

It feels weird to consider an increase of coding audits to be a benefit of ICD-10 implementation, but that's what Susan Belley is going for in her Health Management Technology column.

Belley writes that audits are more frequent because healthcare professionals don't have as much ICD-10 expertise as they had ICD-9 expertise. So they need the audits to know if their coding is accurate and optimizes revenue.

Doesn't sound like a benefit but by increasing coding audits, healthcare providers improve documentation, coding accuracy and quality outcomes data. This is going to lead to better revenue cycles.

Belley also had some tips for maximizing the benefits of coding audits:

  • Prebill audits should be done daily to catch errors that could affect high-risk reimbursements.
  • Retrospective audits should be done regularly for each medical coder.
  • External audits can catch issues that internal audit staff may overlook.
  • Audit teams should be comprised of medical coders, documentation specialists, physicians and patient safety professionals.
  • In addition to determining coding accuracy, audits should also determine reimbursement accuracy.
  • Develop a coding audit plan.
  • Share all auditing findings with the staff.

This isn't about finding fault with how the staff handles ICD-10 coding. This is about ensuring coding quality to maintain revenue and patient health.