News: ICD-10 productivity survey respondents share challenges, successes

In general, the time spent reviewing and coding records has increased since ICD-10 implementation for most record types, according to a recent ICD-10 productivity survey conducted by HIM Briefings.

The majority of the anonymous respondents—12% of which were CDI specialists—have seen at least a slight decrease in productivity. For inpatient records, the majority reported spending 20-30 minutes per chart pre-implementation. However, post-implementation, the majority said they spend 30-60 minutes per chart.

Slightly more than 26% of the respondents had no CDI program; 11.8% of respondents shared that their CDI programs were new and had been in effect less than 12 months.

A number of respondents attributed CDI involvement to their implementation success, in particular relating to physician education. One respondent said, “CDI held lunch and learn meetings for the providers once a month prior to ICD-10, to prepare for kickoff. Physicians are asking now for it to return; we plan on starting with once a quarter.”

Conversely, those that struggled post-implementation noted a lack of CDI involvement. “Our challenges have been lack of a CDI program to assist with provider education,” said another respondent.

A number of factors resulted in productivity decreases, including the quality of documentation with the new code set. One respondent noticed a variance in productivity based on the physician who documented the records, saying that some providers are quicker to pick up on the ICD-10 language. Others—37.4%— did not recruit additional staff to meet the challenge of ICD-10. Those that did (18.2%) obtained staffing from a contract service, which allows gradual independence from the contracted staff as a facility's own staff gains familiarity with the code set.

CDI and coding must work together to maintain or increase productivity in the new code set, according to Monica Pappas, RHIA, president of MPA Consulting, Inc., in Long Beach, California, who said, “I am an observer that without the collaboration between CDI and coding, results are never as optimal as possible." 

Editor’s Note: Survey results and analysis were originally published in HIM Briefings.