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Providers reaching the critical point in ICD-10 education: Q&A

By Jennifer Bresnick

- As the clock keeps ticking down to October 1, 2014, providers who are behind the curve when it comes to their ICD-10 preparations are about to hit a critical tipping point.  With the CMS Testing Week nearly upon us and a worrying number of organizations still barely shifting into gear, ICD-10 education for coders and physicians is no longer an issue that can be addressed at some point in the hazy future.

ICD-10 Compliance Deadline

Michelle Leavitt, Director of Courseware and Product Strategy at HealthcareSource, spoke to EHRIntelligence about some of the biggest concerns providers will be facing in the last few months of this turbulent transitional period.

What are some of the major trouble spots you see at this point in the transition process?

It seems like providers are putting off their training on the ICD-10-PCS component of the code sets.  I saw a survey saying that about a third of hospitals still haven’t started that education, and, unfortunately, the PCS part of the code set is the more complex.  It’s more complex than ICD-10-CM.  It’s 20 times more complex than ICD-9-PCS, so it’s going to be very important over these next couple of months for hospitals and providers to really buckle down and focus on getting that education out to staff and ensuring that coders are competent using that code set specifically.

A lot of organizations started in ICD-10-CM, as they should have, but those initial wins or those initial accomplishments shouldn’t cause people to forget that there’s still a lot of work left. You can’t think that ICD-10-PCS is just going to happen on its own.  If it took you a month to prepare staff for ICD-10-CM, you should plan twice that to prepare staff for ICD-10-PCS because of its greater complexity.

How can providers catch up to where they should be with their educational programs?

I know we all wish that magically there’d be more hours in the day, but I don’t think that’s going happen this year.  What providers have to recognize is that if they haven’t started yet, they have to start today.  There’s no more room for waiting.  There’s no more room for talking.  It’s time to start doing.  And the best way to make that happen on the education front, with only being nine months left, is to find ready-made educational programs from trusted providers, so that there isn’t any time spent creating education or validating whether the education will work.  You have to get something that you can implement tomorrow or next week.

How should transition team leaders introduce these materials to their coders and physicians?

I think that in most cases it’s going to be better to spread out the education.  I wouldn’t say it should be in slow drips, but I think to put them in a room for nine hours is too much.  Educational theory clearly says that that sort of information overload is not going to get the outcomes that these coders have to have.  They need to understand the code set and be able to use it, and one nine-hour marathon isn’t going get them to that result.

We continue to recommend that hospitals and providers utilize more of an ongoing training program where perhaps the education occurs over two or four weeks.  The coders should be spending two, three, four hours a week on the education when it makes sense for them, so that they have the flexibility in their schedule to do it when it makes sense.  You don’t want them being forced to do it at a time when it doesn’t work for them.  Being required to attend a session that takes them away from their other responsibilities will also make them less receptive to education, which will negatively affect the outcome as well.

As they’re providing this education, providers have to keep in mind that coders who have this knowledge set and can demonstrate competence are going to be in real high demand.  For a coder, it’s in his or her best interest to become competent as quickly as they can and be receptive to any sort of programs that might be available to them from their employer or from their community.  From a hiring manager’s or coding manager’s perspective, the more cost-effective way of finding that staff is going to be to train existing staff to a level of competence.  But if they can’t do that, then they are going to have to find that talent within their community, potentially hiring away from other organizations.  That then goes into the whole world of competitive pay packages and paying a premium to lure someone away from the hospital across town, which can just skyrocket the cost of getting the staff in place for this.

Do you think the industry as a whole will be able to rise to the challenge and meet the October 1, 2014 deadline?

I’ve been encouraged by some of the stories and case studies that we’ve seen about some organizations that have made significant progress, so I think that we are going to have a good chunk of the health care system that does scramble its way to the deadline.  There will be challenges, of course, in October, and in November and December.  Even people who have prepared as much as they can are going to find out that there are things that they didn’t think of, or processes that they thought would work well, but when push comes to shove they’re not quite as tight of a process as they expected.

But for those organizations who have prepared, those will be manageable bumps.  I don’t think it’s too late for other organizations that haven’t really started to get there.  We still have nine months.  It will take a full organizational commitment, and it will probably require a greater expense at this point than it would have if the organization had started two years ago, but it can be done if the organization is willing to focus and commit.




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