Vice President, Portfolio Architecture & Integration, Streamline Health, Inc.
We all know that ICD-10 will bring with it a learning curve for coders at provider organizations. Despite all our preparations, training, and dual coding scenarios, there will be an impact to the revenue cycle in terms of higher DNFB due to longer coding times and possibly reduced revenue due to missing specificity.
Next week, when we all begin managing the transition to ICD-10, here are five ways for providers to stay ahead of the curve, minimize DNFB and optimize reimbursements and cash flow.
1. Workflow Efficiencies
Your coding distribution processes need to be spot on. Fully automated workflows which include high dollar distribution algorithms will make sure you’re working on the right cases in the right order. Give special attention to any work distributed manually, as well as items that may put the case on hold (e.g., missing documentation and outstanding queries.)
2. Solid Query Process
We know physician queries will increase under ICD-10. Therefore, every aspect of your query process should be reviewed. If not already in place, a fully automated query solution which can be accessed by CDI nurses as well as coders is essential. Develop well-defined query templates, as well as automation to suggest queries when non-specific codes are encountered. Automatic notifications and responses will help ensure physicians and documentation specialists are working as efficiently as possible.
3. Put Pressure on Slow Responders
Having a way to measure query response rates is critical to ensure compliance. And being able to show potential dollars lost from cases that couldn’t wait for the physician response is a compelling metric for upper management, especially when addressing the issues with unresponsive physicians.
4. Coordination and Communication with CDI
Review the coordination between your CDI specialists and coders. Coders should have integrated access to all case reviews, notes, queries, and working DRG history compiled by CDI as well as an integrated, easy way to communicate on cases.
5. Computer-assisted Coding (CAC)
Implementing CAC is not a quick-fix as it requires time and resources to implement. However, by empowering your coding operations with Natural Language Processing (NLP), you can help transform your coders from code finders to coding auditors, allowing them to fully utilize their coding skills and training.
The transition to ICD-10 will impact coding and revenue, but it also presents an opportunity to implement best practices throughout your coding operations that will yield positive results long after completing the transition to ICD-10.