Mary Pat Jackey BSN, RN Clinical Educator Commonwealth Health Corporation Bowling Green, KY. Learning Objectives. Learn industry best practices for:

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1 Be Ready for ICD-10 Best Practices for Educating Coders Mary Pat Jackey BSN, RN Clinical Educator Commonwealth Health Corporation Bowling Green, KY Michelle Leavitt Director, Learning Solutions HealthcareSource Clifton Park, NY Learning Objectives Learn industry best practices for: Assessing coders Delivering targeted, tailored ICD-10 education Hear a specific case example of success stories from Commonwealth Health 1

2 INDUSTRY BEST PRACTICES Step 1: Determine current knowledge 2

3 Thought Exercise $2, Avg Savings = $471/coder $1, $1, $1, $1, $1, $ $ Basic CPC CPB $ $ $ hours 40 hours Step 2: Foundational education Anatomy & Physiology Basics of ICD-9/ICD-10 3

4 Step 3: In-depth coding instruction Step 4: Practice, practice, practice Case studies Practice documentation Dual coding 4

5 Step 5: Celebrate! Step 6: Keep it going 5

6 COMMONWEALTH HEALTH S EXPERIENCE Overview Commonwealth Health Corporation(CHC) 4 hospitals ~ 3100 employee s, numerous healthcare facilities and physician practices. 9 physician practice coders 13 Inpatient Coding Specialist 8 Clinical Documentation Specialist 6

7 What we knew in the beginning: ICD- 10 training was going to require more than sending medical coders to classes to learn diagnosis codes. Would need to identify staff members who will need training. Only Coders have to re-learn how to code! Everyone else just has to understand the change in the process and concentrate on improved, more specific documentation. Identify what level of education and awareness are needed for each set of staff members. Plan Training Basic awareness training to key stakeholders Senior management, IT, clinical department managers, medical staff, etc More Intense awareness training guidelines, codes All currently involved with ICD data Role based training Organization ICD-10 Coding Training Provide Training based on knowledge gaps Begin with new structure and definitions, guidelines and move to more intense training 7

8 Major changes from ICD-9 to ICD-10 Not just the usual annual update ICD-10 markedly different from ICD-9 Major changes to the coding and billing systems for all healthcare services and payers. Requires changes to almost all clinical and administrative systems Requires changes to business processes Changes to reimbursement and coverage MANDATORY compliance by October 1, 2014 Number of Codes 8

9 What Did We Do First? Steering committee which consists of key stakeholders (2011) Executive Leaders, HIM, IT, Coding, Physician Practice, Financial Resources Department,, Finance, etc Assess level of education needed for each group (coders, nursing, physicians, ETC) Everyone will NOT need same level of Education Mandatory Will cost time and money Education documentation requirements Classroom versus Online Training Things to think about?? Should staff be paid for this training? Should it be done during work hours? How do you handle loss in productivity? Should there be deadlines for assignments? Should all coders work on same lessons every week? Do you need per diem coders during staff training? How do I document staff training and proficiency tests after training? 9

10 What Did We Do? (2012) After careful review we purchased 16 E-Learning courses from a vendor that would integrate with our Learning Management System. Anatomy and Physiology Pathophysiology and Pharmacology ICD-10 PCS and ICD-10 CM components Specific Assessments and Courses CEUs Easy assignment Easily Track completion of courses Self paced Test preparation 1 year to complete (Ongoing Education) Timeline of Completion Coders and Clinical Documentation Specialists I year to complete (Jan 1, 2012-Jan 1, 2013) Each coder was given designated time during their work schedules to complete the E-Learning modules. Anatomy and Physiology Pathophysiology and Pharmacology Then instructed to complete assessments, courses and exams as assigned. 10

11 So where are we now? E-learning modules (coders, CDI) 2013-Coders are receiving Advance Training through outside online vendor. Dual Coding Using Translator Tool Vendor Readiness Payor Readiness Where are we now? Physician ICD-10 Newsletter every month ICD-10 icon Doctor Day Office Manager/Billers/Coders Lunch/Breakfast Updated all forms - changed to include ICD-10 language Revenue Cycle Testing Dual coding 11

12 Summary Every health care professional should have a basic understanding of ICD-10 One size does not fit all when educating staff Early planning is key to successful implementation Take advantage of every minute left Monitor resource sites for information 12