HRAA's Industry Pulse: Nation-Wide Survey Identifying ICD-10 Dual Coding Efforts

Small- and Mid-Sized Hospitals Behind in ICD-10 Transition 

A recent survey of hospital administrators, hospital health information professionals and compliance employees found that one in five small- and mid-sized hospitals have not begun any education or training for the biggest shift U.S. healthcare organizations have ever faced – the transition from ICD-9 to ICD-10.

Of the more than 120 hospitals surveyed by Health Revenue Assurance Holdings Inc. (OTCBB: HRAA), a provider of technology and revenue integrity solutions for healthcare organizations, approximately half are not following official Centers for Medicare & Medicaid Services (CMS) timelines on preparing for the ICD-10 transition.

“The shift from ICD-9 to ICD-10 is equivalent to learning another language; it will not be as easy as flipping a switch. HIM coders must be exposed and then trained on the fundamentals of ICD-10 to ensure that a hospital’s revenue system remains intact and that millions will not be left on the table when the transition takes place,” said Andrea Clark, chief executive officer of HRAA. 

Survey Highlights:

Of the hospitals surveyed:

• 40 percent have not begun ICD-10 CM training for coding staff;
• 55 percent have not begun ICD-10-PCS training for coding staff;
• 47 percent have not begun document improvement education for medical staff;
• 31 percent do not plan to dual code prior to October 1, 2014.

“At HRAA, we work with our clients on dual-coding initiatives where they code the claim in both ICD-9 and ICD-10,” said Ms. Clark. “By coding in both formats, combined with utilizing business intelligence and analytics solutions like HRAA’s ICDVisualizer™, hospitals can map out what the risks are, where they need to focus their training efforts and be prepared so they will remain revenue-neutral when the transition comes.”

Clark continued, “Education and training is the technical lock for ICD-10 dual coding. Documentation improvement is the key foundation for dual coding efforts for both inpatient and outpatient encounters.  Hospital’s ICD-10 coded data tomorrow is only as good as the documentation provided today. A hospital with a lock and key will open the benefits for dual coding.” 

While CMS recommends that hospitals conduct internal and external testing in 2013, the majority of respondents stated that they do not plan to start to dual code accounts until 2014. Twenty five percent plan to start in January 2014, 24 percent plan to start in April 2014 and 13 percent plan to begin in July 2014 or later.

Even though respondents indicated that hospitals are delayed in conducting the proper training and testing, 68 percent said that they do plan to submit ICD-10 coded claims to payers for testing prior to the transition.

“We were encouraged by the fact that hospitals plan to work with their payers prior to the transition,” Clark commented. “However, it’s important that hospitals understand that it’s critical that both ICD-9 and ICD-10 data needs to be stored during this process. It is imperative that they stay in contact with their vendors – both their encoder and patient accounting systems – to monitor when this function becomes available, as this is precious data that a hospital does not want to lose.”

Based on the data from the survey and HRAA’s industry expertise, the company has developed three key recommendations for hospitals as they re-examine or start ICD-10 implementation:

1. Hospitals must contact and engage in regular updates from vendors regarding dual storage of ICD-9 and ICD-10 data. 
2. Hospitals must utilize dual coding to benchmark with continued progress in order to mitigate financial risks for all payers.
3. Hospitals must orchestrate dual coding results for consistency and integrity with a dedicated feedback modality.

The majority of hospitals surveyed have between one to 400 beds. Key job titles include: health information professional, chief technology officer, manager/supervisor, director, and compliance staff, all of which have coding responsibilities. 

About HRAA
HRAA is a leading provider of revenue integrity technology and services for healthcare organizations across the US, interpreting data to ensure that healthcare is efficient and effective for everyone.  Founded in 2001 and based out of Plantation, FL, HRAA combines years of industry expertise with best-in-breed technology to create market leading business intelligence products and consulting services to improve the healthcare delivery experience for doctors, nurses and patients.  HRAA offers the only full suite of solutions needed to keep up with the ever-changing healthcare industry, which include: data analytics software, business intelligence technology, medical coding, auditing, education, revenue cycle consulting, and ICD-10 transition solutions. For more information, http://www.hraa.com.