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ICD-10: Learn from the past, prepare for the future

Now is the time to go back to your ICD-10 transition team and do a post-mortem of all your preparation efforts to assess what your agency was able to accomplish, what it has yet to achieve, where your training was effective and what areas you may have neglected.
Determining the most effective approach to ongoing preparation efforts will depend on your agency’s level of preparedness at the time of the delay, says Trish Twombly, HCS-D, senior director for DecisionHealth in Gaithersburg, Md.

For example, those agencies that were diligently preparing and following recommended timelines that called for the dual coding of 10 charts a week by April 2014, should scale back their dual coding efforts, but not stop them completely, Twombly says. Instead of dual coding 10 charts a week, now maybe just do two.

It’s important to see that all the time, effort and money that’s been invested in ICD-10 to this point isn’t wasted, she says.

Assess gaps & reset training timeline

Reset your ICD-10 training timelines, and if you haven’t been working from a timeline, now’s the time to get on one, says Ann Rambusch, HCS-D, president of Rambusch3 Consulting in Georgetown, Texas.

Currently, coders should focus on mastering or maintaining knowledge of ICD-10 fundamentals, like the guidelines and conventions. Intensive training should’ve started in January  and continue through April, at which point dual coding should commence, says Judy Adams, HCS-D, president of Adams Home Care Consulting in Asheville, N.C.

Also, look for other areas that may have been neglected in your training efforts to date. For example, many agencies have overlooked the importance of training their intake staff in the increased documentation demands of ICD-10, Twombly says.

However, it’s these people who are in a position to ensure that critical information about patients’ diagnoses, required to properly code in ICD-10, is received from referral sources up front, she says.

To combat this training gap, make a list of the top 20 to 25 diagnoses that your agency treats, such as congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), and then create tools that can be given to intake staff to help alert them to when they will need to ask for more specifics about a diagnosis, Twombly says.

Such a tool aimed at the common diagnosis of CHF, for instance, might prompt the intake person to push the referral source to confirm whether the patient’s condition includes diastolic or systolic features, she says.

2 more tips to stay on course until Oct. 1, 2015

• Stay in touch with your software vendor. Home health software vendors have varied tremendously in their readiness levels for ICD-10 and this will impact your training timeline. If your vendor has already allowed for dual coding, ask them whether they continue to make that available, Twombly says. If they haven’t, ask them if they plan to continue development toward allowing for dual coding.
• Provide coders with way to stay connected to the broader coding community. This allows them to keep up on news and to learn from what other agencies are doing, Rambusch says. However, it’s preferable to invest in a subscription to an expert-reviewed publication versus interacting through online forums and list servs.

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