ICD10 Update: Statistics on Accuracy and Deficits
ICD-10 has been implemented for several months now, and it has become clear which issues are impacting proper code selection and payment. A recent webinar given by the National Research Corporation discussed multiple deficits as being attributed to productivity loss: referral source documentation deficit represented nearly 39%, clinical documentation deficit was shown at just over 30%, coder knowledge represented 19.44%, and lastly software vendor readiness impacted productivity loss approximately 14% of the time.
On average, a professional coder who was able to code 25 charts per day before ICD-10 implementation is now likely to code as few as 15 cases per day with an accuracy rating of only 72%. Professional reviewers who code charts and perform OASIS review for consistency and who formerly had the ability to perform 15 charts in ICD-9, are now reviewing about 10-13 charts per day after the ICD-10 implementation, again with an average accuracy rating of 72%. Prior to implementation, both professional coding tasks had typical accuracy ratings of over 95%.
Another issue discussed in the webinar was the basic lack of knowledge of anatomy and physiology, pathophysiology, pharmacology and medical terminology. It was shown that professional medical coders should strive to maintain their knowledge base by taking current courses, available through online programs or at many local colleges. These courses will improve the coder’s ability to accurately review medical documentation, which will lead to more accurate code selection.
The following common coding errors were identified during the webinar: missing the 7th character, laterality, and ulcer severity, sequencing errors, and the use of unspecified and invalid codes. These errors fall into the top three categories listed above (referral source documentation, clinical documentation or coder knowledge deficit) and can be remedied with education.
QIRT offers a variety of courses to supplement clinician and auditor knowledge on ICD-10 documentation, anatomy and physiology, and general ICD-10 conventions and guidelines.