Timing is no longer a question in ICD-10 training

By Carl Natale
09:06 AM

We're past the point that we can debate the timing of ICD-10 training. Start ICD-10 training now.

It's that simple.

Maybe actually training your staff to document properly and assign the right medical codes is a bit more complicated. OK, it is. The American Medical Association's (AMA) free educational resources has a fairly nice outline for planning your ICD-10 training. Throw in some tips from the Centers for Medicare and Medicaid Services (CMS), you have a really good start.

Identify staff members (including clinical staff ) who need training on ICD-10

And you need to decide the level of training needed for each staff member. There are three levels of training that need to be planned:

  • ICD-10 code training

    • Medical coders

      • ICD-10-CM/PCS code set
      • Anatomy and physiology refreshers
      • In-house trainers

        • Medical coder with ICD-10 training
        • Train co-workers
        • Skills:

          • Public speaking skills
          • Comfortable with change and learning
          • Ability to organize and plan training sessions
          • Desire to do more than coding
    • Dual coding

      • Assign ICD-9 codes and ICD-10 codes before Oct. 1, 2014
      • Advantages:

        • Medical coders can practice their ICD-10 knowledge
        • Clinical documentation deficiencies are exposed
        • Extensive internal and external testing can be done
    • Non-coding staff members

      • Educate IT staff about requirements and structure of ICD-10 code sets
    • Coding champion

      • Staff member with ICD-10 training
      • Educate and create awareness among the non-coding staff
      • Help understand what vendors are selling
      • Plan implementation and testing
  • Awareness

    • Start immediately
    • Where to start
      Source: Overlooking Little 'C' Coders Puts ICD-10 At Risk

      • "Patient Registration"
      • "Central Scheduling"
      • "Utilization Review"
      • "Quality Improvement"
      • "Ancillary Departments: Lab, Rad, Respiratory, Etc."
      • "Infection Control"
      • "Patient Accounting"
      • "Dietary"
    • Create an education plan that fits their schedules and needs

      • Explain how their work with ICD-10 codes will affect reimbursement.
      • Assess what they need to know:

        • Major differences between ICD-9 codes and ICD-codes
        • ICD-10 cheat sheets
    • Regular communications with management, IT staff and medical staff about:

      • Differences between ICD-9 and ICD-10 code sets
      • Differences between ICD-10-CM and ICD-10-PCS code sets
      • Regulatory requirements
      • Value of ICD-10 code sets
      • How ICD-10 implementation works with other initiatives
      • Impact on coding productivity and accuracy
      • Budget impacts
      • How the transition will impact departments
      • Impact on physicians' time
      • How ICD-10 coding could affect patient encounters
      • Updates on progress of the ICD-10 transition
    • Recruit physicians and other clinicians to help champion your ICD-10 project. This has two key benefits:

      • Physicians and clinicians will be more influential in getting colleagues to cooperate. Which will come in handy when they learn they need to add more detail to documentation.
      • Physicians and clinicians can offer reality checks to how things really work in your practice. Something that the IT staff or consultants may not be aware of.
    • Consider expanding their coding skills and knowledge to make up for lost productivity.
  • Procedural training

    • New procedures and systems

      • How to use new software and tools

        • Electronic health records (EHRs)
        • Computer assisted coding (CAC) systems
        • Practice management systems
      • New forms such as superbills
      • New billing and claims procedures
      • New documentation procedures
    • Clinical documentation improvement (CDI) initiatives

      • Impact on documentation
      • CDI strategy

Identify an office expert on ICD-10

This could be a physician, medical coder, administrative staffer or consultant. You need someone who understands the ICD-10 code set and what needs to be adapted.

If this expertise doesn't exist in your medical practice, then hire a consultant or send someone to ICD-10 training ASAP.

Create a training plan

These questions will help plan ICD-10 training:

  • "On which ICD-10 code sets do we need to receive training: ICD-10-CM (diagnoses), ICD-10-PCS (inpatient procedures), or both?"
  • "Who should be trained on the ICD-10 code set?"
  • "How long will it take to train the staff?"
  • "Which training method will work best for our staff: classroom training, web-based training, written materials, or hiring a consultant? Why is this the best method?"
  • "Would a “Train the Trainer” system (i.e., one staff member receives training, then trains the rest) work for our staff? Why or why not?"
  • "Where can we obtain the training?"
  • "Will there be downtime during the training? If yes, approximately how long? What action will we need to take?"
  • "What resources do we need to support the staff after training?"
  • "When should training be completed?"

Begin staff training

Not everyone needs to know everything about ICD-10 coding. Start preparing personnel for what they need to know and get them scheduled for the right training.

Complete staff training

Actually, I'm going to disagree with this one. Training will probably never end. At least keep physicians actively thinking about clinical documentation.

Incorporate ICD-10 training into new employee orientation

Basically, don't assume everyone knows what it takes to be ICD-10 compliant.

Implement monthly or quarterly ICD-10 review sessions after training is complete

Maybe this is why I don't think ICD-10 training is complete.

If you start your staff on a steady diet of ICD-10 and documentation training, you can keep them engaged through the rest of the year. Then they will not forget what they learn. But the key is to start now.