Health Information Management

News: Poll shows facilities starting dual coding in January

CDI Strategies, December 19, 2013

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According to an informal ACDIS poll, 66% of facilities plan to begin dual coding for ICD-10-CM/PCS in the first quarter of 2014. At Cedars-Sinai in Los Angeles, administrators made the decision to begin dual coding even earlier.

“We wanted to have a significant amount of time to perform dual coding to gather as much data as possible so we can analyze our weak spots and have an opportunity to improve our documentation,” says Colleen Stalvey, RHIT, manager of CDI at the facility.

On Oct. 1, 2013 Cedars-Sinai partnered with a consulting company and doubled their coding staff, practicing dual coding with 100% of their inpatient records. . Beginning in January the facility will also begin dual coding for outpatient records, with an end goal for all records (inpatient and outpatient) to be dual coded by April 2014.

“It has been quite a journey already,” Stavely says. “Now we have to start pulling some data together from the first few months to see how we are doing against our high risk areas.”

They have already learned a lot, she says, about how well payers are prepared, about validation concerns, about how the added ICD-10-CM specificity affects CC/MCC assignments, and how implementation affects productivity levels.

The primary lesson, however, centered around changing the CDI focus away from individual queries to providing focused education to physicians.

“We’ve seen the increase in query opportunities,” she says. “But we need to focus on the digestible bits of information that we can take back to the physicians to improve the documentation. This year of practice is going to be instrumental.”

Editor’s Note: Stalvey discussed her program’s efforts in relation to ICD-10-CM/PCS dual coding during the November 2013 ACDIS Quarterly Conference Call.

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