Health Information Management

Q&A: Coder productivity changes after ICD-10 implementation

JustCoding News: Inpatient, June 6, 2012

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QUESTION: Do you predict coder productivity will decline as a result of ICD-10? If so, what do you think the declines will be six months after implementation?

ANSWER: These are just my predictions, but I think that inpatient cases are going to drop to 2.5–3 records per hour. Currently we’re upwards of 3–3.5 per hour in non-teaching/tertiary environments.

On the ambulatory surgery side, I think those are going to drop to 5.5-6.5, and I really think it will be closer to the 5. HCPro’s 2011 Coder Productivity survey results show coders completing 6 -7 cases per hour now. And the reason I give those estimate is because we’re going to have more of a challenge with the surgeons giving us the information that we need in order to provide the complete surgical code. So I really do think it will be the lower end of that range.

And if you’re one of those facilities that codes today in both ICD-9 and CPT® and if you can continue that practice in ICD-10 and CPT, then you’re going to have more of a reduction, closer to 4 cases per hour just because of the two different thinking patterns for the two coding classifications.

For non-interventional radiology outpatient testing cases, we’re averaging approximately 25–30 per hour right now. I think we’ll see a range of 23–26.

The area of non-interventional outpatient test coding could really benefit significantly from computer assisted coding (CAC) applications. I encourage you to think about getting a CAC application early on and start using that for those simple outpatient cases, where it is single or a few codes. Transition those coders over to the next level of coding, for example ambulatory surgery or inpatient cases, so that you’ll have more staff available to you to assist with potential loss of productivity on the inpatient side.

Editor’s Note: Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, chief operating officer of St. Louis–based First Class Solutions, Inc., answered this question during the February 29-March 2 “JustCoding Virtual Summit: ICD-10-CM and ICD-10-PCS.”

This answer was provided based on limited information that was submitted to Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

Need expert coding advice? Submit your question to Senior Managing Editor Andrea Kraynak, CPC, at, and we’ll do our best to get an answer for you.

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