Is Nursing Butting Heads With Your ICD 10 Coders? Clinical And Nursing Practice Implications That Impact Coding.

August 21, 2021
Bridging The Gap Between The Coding And The Clinical:
The reality of ICD 10 coding is that the RN has to have his or her name on the document. So, when there is coding and clinical conflict, nurses have the right and the duty to question before their names are on the 485. When speaking to nursing staff, encourage questions and dialogue between the two departments. Nurses should question what doesn't make sense to them. Ultimately, the coder is just as capable of human as error as anyone else. So, if it doesn't make sense, then the RN should question the coder. Second, we often see nurses disagree with the order the diagnoses are listed on the 485. This is especially common for seasoned nurses who were in the field prior to ICD 10. Based upon the rules of coding, the order of the list may make complete sense when following coding today's guidelines. Simply having an open dialogue between coding and nursing can remedy this issue in the future. 
If you have in-house ICD 10 coding, then it may make huge sense to invest some time into some basic education to nursing staff from the coders. This can clear up future questions and issues nursing may have with your coding. If you outsource, then have your coding solution assign key contacts to complete your coding. It becomes very frustrating for nursing staff if they do not have a primary contact they work with often. You can certainly see where there is a lack of trust or rapport between coding and nursing if the RN never speaks to the same coder. Next, your coding solution should be willing to work with nursing staff to alleviate any questions or concerns from nursing. If they are not, then you don't have the right solution on your home health team. 
Kenyon
 
Homecare Consulting Can Be Your Complete Coding Solution:
At Kenyon Homecare Consulting , we have seasoned certified ICD 10 coding solutions that can complete basic coding up and through review of the Oasis and 485. Let us help bridge the gap between clinical and coding by providing skilled staff to complete your coding and work through the needs of the nursing staff in your agency.  Call us at 206-721-5091 or contact us online to see how we can help you today!

Results Based Consulting

Did you find value in this blog post? Imagine what we can do for your home care or hospice agency. Fill out the form below to see how we're leading the industry with innovation, affordability, and experience.

Contact Us

plan of corrections
By Ginny Kenyon February 16, 2026
For a Plan of Correction to be effective, it must address the "Who, What, Where, When, and How" of the correction. It is the formal response to regulatory error.
Survey readiness binders
By Ginny Kenyon February 10, 2026
Preparing for a CMS survey in home health or hospice requires shifting from "crisis mode" to a culture of continuous compliance. Preparation prevents surprise!
survey success
By Ginny Kenyon February 7, 2026
CMS survey readiness is about compliance with the Conditions of Participation (CoPs). Surveyors evaluate care in home visits, record review, and staff interviews.
home care licensure
By Ginny Kenyon February 4, 2026
Home care agencies are finding it more difficult to secure and maintain licenses. Administrative backlogs to new federal mandates threaten viability to small providers.
home health consultant
By Ginny Kenyon January 29, 2026
The home health industry is highly regulated, competitive, and constantly evolving. A qualified consultant can save time, reduce mistakes, and accelerate success.
Oasis accuracy
By Ginny Kenyon January 26, 2026
OASIS and ICD-10 coding influence decision-making, reimbursement, quality reporting, and agency performance. Ensuring accuracy is essential for every home health.
chronic disease education
By Ginny Kenyon January 22, 2026
Chronic diseases account for the majority of healthcare utilization and spending with a disproportionate share of hospital admissions, ER visits & long term costs
Interim Management
By Ginny Kenyon January 20, 2026
An experienced interim manager can provide stability, expertise, and momentum- if the right individual is selected during your time of need and transition.
OASIS success
By Ginny Kenyon January 17, 2026
OASIS plays a critical role in care planning, quality, reimbursement, and regulatory compliance and is also key to success and integrity of Medicare Home Health.
policy and procedure manuals
By Ginny Kenyon January 15, 2026
Policies and procedures serve as the foundation for consistent, fair, and effective operations. Your manual should be a living breathing guide for your agency.