ICD-10: View from a Coding Supervisor

Tracy OvertonI remember when I started coding in November 1985, one of the first things my supervisor told me was, “Don’t worry about memorizing codes; we’ll be going to ICD-10 soon.” 

Fast forward to January 2011 – Floyd Memorial Hospital and Health Services officially forms an ICD-10 implementation committee. The committee enlists the expertise from all essential areas of the organization, including revenue cycle to physician champion, CFO and everyone in between. 

The committee outlined a strategy to ensure successful conversion to the ICD-10 code set by creating a plan that includes performing systems evaluation/testing, verifying vendor readiness, analysis of potential revenue impact, staff and physician education. The committee will remain active after Oct. 1, 2015 to address any unforeseen issues that will undoubtedly be identified, as it is our goal to keep those issues at a minimum.

Floyd Memorial participated in end-to-end testing with Medicare in March 2014. Testing consisted of ICD-10 coding 50 inpatient and 50 outpatient records. Claims were submitted through our clearinghouse to Medicare. We were delighted to hear the testing was successful as this was our first opportunity to perform any testing outside the organization. A few weeks later we tested with Medicaid with the same successful results. This was followed by another successful test with a commercial payer, Cigna.

Moving forward, we will continue to volunteer for any testing opportunities that are offered by payers. Our Coding and ITS staff attend monthly ICD-10 preparation calls (with McKesson). These calls are a great opportunity to network with other hospitals using the same application.

Several coders attended a four-day coding seminar to begin learning the new coding system in 2012. This was followed by all coders and clinical documentation nurses completing on-line training courses. This intensive training consisted of completing 22 ICD-10-CM and PCS coding modules that were assigned based upon coder specialty (e.g., inpatient, outpatient or clinical documentation). Each employee had to pass a test at the end of each module. They practice their newfound craft by each coding the same patient records and comparing their coding at monthly section meetings. This proved to be very educational as it opened up great dialogue for coding discussions, not only related to ICD-10, but coding in general.

The clinical documentation staff also plays a major role in physician education regarding documentation needs for ICD-10. They are attending physician meetings and are already starting to word their queries.

When the delay was announced last year, we did slow down a bit to catch our breath, but in January 2015 we regrouped and are picking up right where we left off. The team is looking forward to a successful conversion to ICD-10 with minimal disruption in our revenue cycle.

Tracy Overton, CCS, is the Coding Supervisor at Floyd Memorial Hospital and Health Services. Tracy began working at the hospital as a unit secretary in 1978 while still in high school. She transferred to the Medical Records department in 1979 performing different jobs before finally transferring to the Coding department in 1985. She received her CCS certification in 2001 and has been the Coding Supervisor since 2004.