What's Your Check And Balance For ICD-10 Coding? Do You Even Have One Today?

In today’s complex world of ICD 10 coding, you need to make sure you receive all the dollars you deserve to care for the patients you see. And although this is something directly related to compliance and reimbursement, we rarely check competency on our ICD 10 coders. Let’s consider what a coding check-and-balance system looks like for your agency.

How Do You Do An ICD 10 Check-and Balance?

In our industry, we have competencies and supervision on everything and everyone. So, why don’t we check the accuracy of our own coding departments? If you haven’t put a check-and-balance in place, then now is the time. You need to start with a sample of previously coded charts in your agency. We would suggest 5-15 charts depending on the size of your organization and the number of certified coders you have on staff.

Contact an outsourced company and ask them to evaluate the charts and code them accordingly. Then evaluate your results. You should see only slight differences. For example: Your agency has 4 diagnoses on the 485. The outsourced company agrees with the diagnoses, but the order in which they are on the 485 if different. If this does not impact the dollars paid to your agency, then it is not a big difference. However, it could mean something different if the second diagnosis is weighted. If the diagnoses are very different, you have a problem. This is a process that should be completed yearly.

So, What Comes Next:

If you have a problem, then you need to decide what the issue is. Is it a lack of knowledge? Maybe your coding department isn’t requiring the amount of documentation to justify the codes being used. Maybe you still have someone who isn’t coding certified doing Oasis and coding review? Ultimately, Kenyon Homecare Consulting has a comprehensive ICD 10 coding department and can help be your complete solution, your back-up plan, or your ongoing check-and-balance. We will offer your first 5 recodes for free on your check and balance. Call us today at 206-721-5091 or contact us online .