What Does ICD 10 Coding Mean To An Administrator? Potentially 20% More In Your Pocket.

ICD 10 coding is probably not something consistently on your mind. Normally coding runs like a well-oiled machine unless you find there is a problem. Let’s look at those potential issues and whether or not you are getting the most from your ICD coding dollars.

Evaluate Your ICD 10 Coding Solution:

The problem with many coding solutions is that they don’t fit the needs of the individual agency. Believe it or not, we still see agencies using ICD 10 coders who are not certified in coding and Oasis. Since the items go hand-in-hand, the people reviewing your charts need to be certified in both. In order to evaluate your current coding solution, you need to ask what the solution actually provides your agency.

1. An ICD 10 Code: If this is all your solution provides, then you need to look at other alternatives. An ICD 10 coding solution should improve your Oasis accuracy, give you useful data in terms of education and documentation, and help increase the dollars you receive for the care you provide.

2. Oasis Review: The individual coding your charts should be reviewing Oasis for accuracy. Your reviewer should identify trends in Oasis errors for the individual clinician and the agency as a whole. This should drive your educational efforts related to Oasis accuracy. In addition, it should also let your agency know if you have clinicians that aren’t making errors in the Oasis tool. If you have an individual nurse or therapist with 95% or greater accuracy on the Oasis, then you can decide if you need to have the tool reviewed by the coder. Look at what the price tag is between having someone code and review the Oasis for accuracy or just code the chart based upon the documentation. Your solution should provide you the data you need to make these decisions.

3. Back-up Plan: Are your coders in-house or outsourced? If in-house, do you have a back-up plan in place should one or more of your coders suddenly be out for an extended period of time? What about your outsourced solution? Many are unaware of the answer to that. If your outsourced provider suddenly loses staff, do they provide a guarantee that your codes won’t be late getting to you? Along the same lines, have you inquired what level of surge your outsourced or in-house solution can provide? The answer is to have a back-up plan in place either way. Even an in-house coding program should have an outsourced provider ready to assist in times of surge or extended absence of your staff.

4. Keeping Up-to-date: How does your solution keep up on coding changes? Ask them. What websites do they search to keep connected? What correspondence is received and what educational offerings do they attend?

5. Compare Your Providers: Look at multiple providers of coding whether you currently have in-house coding or not. Compare and contrast costs versus what is provided by each. Have the outsourced coders recode charts that have already been reviewed. See if the codes match. If they don’t, then find out what one provider sees differently than the other when looking at the same chart. Does one provider’s coding elevate the dollars you receive while still holding true to the rules of coding? The truth is that Kenyon Homecare Consulting has been able to provide agencies up to 20% more in reimbursement than the current coding provider. This is the reason we say for agencies to evaluate the solution they currently use and make sure it continues to consistently meet the needs of your organization.

ICD-10 coding is complex and its importance is sometimes overlooked because there are so many other things to do as an administrator. Ultimately, don’t lose dollars or accuracy by going with the wrong coding solution. If you would like Kenyon Homecare Consulting to provide 5 free recodes of charts as a check and balance of your current coding solution or you need us to provide your coding, call us today at 206-721-5091 or contact us online.