Health Information Management

News: CMS demonstrates how to maintain ICD-10 progress

CDI Strategies, April 14, 2016

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An infographic newly released by CMS guides healthcare providers toward better assessing, addressing, and maintaining progress since ICD-10 implementation. Identifying key performance indicators (KPIs) and creating baselines for KPI analysis are important steps in tracking progress, says CMS.
 
Earlier in March, CMS released a fact sheet with examples of important KPIs that could be tracked, such as:
  • days to final bill
  • reimbursement rate
  • coder productivity
  • claims denial rate
  • daily charges/claims
 
After identifying facility-specific KPIs and establishing the baseline for each KPI, providers must compare findings to any post-transition KPI, according to the infographic. CDI teams should try to be involved in, as noted challenges can be used for targeted education.
 
 “It’s best to compare metrics with past calendar years by month. Seasons can affect statistics, and you will want to take into account local issues (e.g., impact of staff vacations, flu season),” CMS says.
 
After assessing collected data, providers must address those findings by checking clinical documentation and code selection, verifying system upgrades, and working with payers to resolve billing issues. Lastly, once issues are identified and corrected, CMS says providers can maintain ICD-10 progress by keeping coding tools up to date, remembering that ICD-10 is updated annually, and regularly reviewing coding guidelines. CDI departments can work with providers to identify documentation-related issues that require additional education and information.
 
Editor’s Note: This article was originally published in Just Coding.



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