Engaging in dual coding as the deadline to transition to ICD-10 moves closer to reality is not an optimal strategy, according to Walter Houlihan, director of health information management and clinical documentation at Springfield, Massachusetts-based Baystate Health.
While Houlihan and his team members--who are spread across four hospitals and 80 medical practices--spent a large part of 2014 coding records in both ICD-9 and ICD-10, they now are focusing "building familiarity" with the latter code set to ensure that life after the transition is less cumbersome. Healthcare facilities, he writes in a post for the Journal of the American Health Information Management Association, must "bite the bullet" and provide coding staff enough time to learn the system properly.
Starting this past March, Baystate required individual coders to spend one day a week coding solely in ICD-10 (with the records subsequently being completed in ICD-9 by coders not on their designated day). In June, Baystate upped the designated ICD-10 coding days to two per week.
"Giving coders blocks of time to focus on ICD-10 allows them to only think about ICD-10, thus allowing more focus than is possible when having to switch back and forth continuously between ICD-9 and ICD-10," Houlihan writes. "This method also provides management with information on productivity impact related to ICD-10."
The American Hospital Association repeatedly has called dual coding after the Oct. 1 deadline an unworkable proposition. For instance, as part of the Coalition for ICD-10, AHA, the College of Healthcare Information Management Executives and others in March asserted that allowing dual coding to protect small physician offices following the deadline would be equivalent to another delay.
And in a statement to the Senate, Health, Education, Labor and Pensions Committee that same month, the AHA again said dual coding cannot be an option.
"That approach would require payers to run dual systems," AHA said. "Many hospitals support physician practices using a team of professional coders. It would be very confusing and add cost for them to code under both systems at the same time."
Houlihan says his coders are calling the experience a positive one.
"Coders at Baystate have noted that it makes a major difference for them to code with only ICD-10 codes," he says. "As one inpatient coder noted, the approach of enabling coders to code records with only ICD-10 helped them to stay focused on the new codes, as well as with increasing overall knowledge of ICD-10."
To learn more:
- read the Journal of AHIMA post