Health Information Management

Tip: Consider the benefits of inter-departmental coding conferences with ICD-10 on the horizon

CDI Strategies, December 22, 2011

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Most of the cases that HIM professionals code are straightforward; some are more difficult, and a few just drive them crazy. Consider the benefits of a departmental “coding conference,” which brings the HIM staff, CDI specialists, and other interested persons together on a regular basis to discuss thorny cases and coding issues. Joel Moorhead, MD, PhD, CPC, and Cheryl Weibel, RHIT, suggest these gatherings provide opportunities for education and serve as a forum for coders and other clinical staff members to share their knowledge and experience.

People from outside the coding/HIM department, such as CDI specialists, physician advisors, practicing physicians, allied health professionals at the hospital (e.g., nurses and therapists), and coding consultants should attend or participate by phone. Most of us find our jobs more satisfying if we feel that others give careful consideration to our views and opinions.
Coding conferences provide opportunities for each person to present and support positions that may immediately and tangibly influence the outcome of the discussion. And once ICD-10-CM/PCS takes effect in 2013, coders struggling with the new coding system will gain valuable insights and helpful support from each other in the early days of transition.
The process of discussion is inherently educational. It’s likely that attendees will learn something valuable from each and every coding conference. Discussions may also help identify individuals whose judgment and experience are especially valuable in certain areas, and those people can become subject-matter experts within the department.
Experience with physician queries over the past month can guide meeting discussions. A large number of queries regarding the same medical condition can point to confusing or unclear documentation by physicians, and can identify individual physicians whose documentation triggers multiple queries.
These meetings can present an opportunity to clarify difficult-to-decipher Coding Clinics for ICD-9-CM. Selected case reviews can identify encoder pathways that may lead to DRG assignments that correspond poorly to the documentation in file.
Consider allotting one hour for each coding conference, and try to discuss two to four cases. People who submit cases for the agenda should present two to three minute summaries of the cases, along with any medical or coding issues that make code assignment challenging. Coding conferences could occur monthly, or at a frequency determined by the number of cases staff members introduce for discussion.
Spending some time upfront during coding conferences discussing these more challenging cases can save time at a later date. Coders may recognize similar situations in the future, refer to cases from past coding conferences, and apply those discussions to resolve these coding dilemmas quickly and accurately.
Editor’s Note: This article was adapted from the original published in the October 25 edition of was written by Joel Moorhead, MD, PhD, CPC, an adjunct assistant professor at the Rollins School of Public Health at Emory University in Atlanta, and Cheryl Weibel, RHIT, director of Health Information Management at Armstrong County Memorial Hospital in Kittanning, PA.

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