Dual Coding: The Key to a Successful ICD-10 Transition

Medical billing and coding ICD-10 readinessAs the official implementation of ICD-10 approaches, healthcare organizations are finalizing plans for managing this transition. One key initiative to prepare for ICD-10 is to implement dual coding. There are many benefits to dual coding beyond providing coders an opportunity to practice including: identification of remediation training needs, minimizing productivity impact after Go Live, assessing clinical documentation for ICD-10 readiness, and analyzing financial impact.

There is no one approach to dual coding that will work for all healthcare organizations, but there are best practices that can be implemented to meet each facility’s needs.

Preparing for Dual Coding

A dual coding program must be carefully designed and implemented in order to be beneficial.

It is important to consider the objectives of dual coding for your organization and to develop a dual coding plan to meet those objectives while minimizing the impact to your organization.

Considerations include assessing your systems’ dual coding capabilities, identifying a timeline, determining the quantity and frequency of dual coding activities, preparing workflows to properly measure ICD-10 coding productivity, identifying and scheduling ICD-10 super users to review dual coding activities and conducting remediation training, and calculating backfill needs, Instead of attempting dual coding for 100 percent of patient records, healthcare organizations have identified that the most efficient and effective strategy is to perform multiple, focused dual coding projects, thereby allowing for the opportunity to thoroughly review each case for accuracy and to identify the DRGs with the greatest risk for lost revenue or that will call for greater documentation in ICD-10.

In addition to calculating costs, also take into consideration the projected long term benefits of the dual coding plan such as improved productivity and coding accuracy.

Creating an Environment of ICD-10 Readiness

The ultimate goals of dual coding are to reduce the learning curve of ICD-10, increase coders’ familiarity and confidence with the system, identify documentation gaps, and reduce the impact of the transition from ICD-9 on revenue and productivity.

Dual coding performance that is carefully monitored allows a healthcare organization to analyze the impact to productivity, identify any trends in under or over coding in ICD-10, and assess the accuracy rates of individual coders. This makes it possible to predict the overall impact of the ICD-10 transition and to know where to make up for losses or gaps to avoid large hits to post-transition revenue.

Above all, dual coding without tracking the results makes this an exercise in futility. Closely analyzing and discussing the outcomes of dual coding can help lessen financial and operational risks. It is recommended to create trials in a safe environment and review difficulties, concerns, and questions with staff.

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