News: Coder productivity expectations under ICD-10 vary

Coder productivity was a hot topic of conversation during the AHIMA pre-conference in Atlanta October 26-27. We all know coders will be less productive initially after the transition to ICD-10. The question is how much less productive?

Different speakers offered different opinions, ranging from a 25% decrease in productivity to a 60% decrease in productivity. Some of those estimates are based on Canada’s experience, some are just best guesses, others are based on pilot studies.

The problem with using Canada’s experience is that Canada only uses ICD-10 diagnosis codes. The U.S. is the only country using ICD-10-PCS.

Hopefully, most people realize that coders will face initial struggles with PCS. It’s a brand new coding system. Inpatient coders will have to look for things they don’t look for now, such as laterality and approach.

ICD-10-CM is very similar to ICD-9-CM. You still need to look for more information than you do in ICD-9-CM (laterality again comes to mind). But if you can look up a code in ICD-9-CM, you can look up a code in ICD-10-CM.

The decrease in inpatient productivity remains a great unknown. The best way to combat the productivity decline is make sure your coders are trained and comfortable using ICD-10-CM and PCS before the transition.

What will happen with CDI specialists’ productivity expectations remains an open question and one that will most likely reflect the changing dynamic related to the CDI programs’ overall goals and productivity expectations.

For example, CDI teams already fluent in ICD-10 documentation specificity requirements will likely see smaller shifts in productivity over time rather than one large decrease at the time of the “go-live” date. Keep in mind that many facilities have yet to implement CDI programs. Those facilities will need to train new staff on appropriate query practices as well as on the idiosyncrasies of the new code set.

Just as there are many considerations regarding CDI productivity today, the same will hold true for productivity measures under ICD-10.

Editor’s Note: This article was adapted from the original as it appeared on HCPro’s ICD-10 Trainer blog.