Report: Only 63% of ICD-10 Documentation Accurately Coded

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In a recent ICD-10 pilot project, healthcare coders were accurate only 63 percent of the time, on average, in their documentation from medical records.

In addition, coders averaged two medical records per hour, compared with four per hour under ICD-9, which equates to a 50 percent drop in productivity.

The results came from the ICD-10 national pilot program, which started in April 2012 and ended in August 2013. The Healthcare Information and Management Systems Society and Workgroup for Electronic Data Interchange released a report on the program, and the groups said ICD-10 coding accuracy varied wildly depending on what was being coded.

For example, "single liveborn, born in hospital, delivered by Caesarean section" was coded accurately 100 percent of the time in a "wave," or batch, of codes. In that same batch, though, "pain in limb" was coded accurately only 33 percent of the time because specificity and laterality — both major components of ICD-10 — were not included.

ICD-10 will become the new norm for hospitals, physicians and other providers starting Oct. 1, 2014. HIMSS and WEDI said the report indicates that many organizations — including payers, clearinghouses and vendors, in addition to providers — need to conduct rigorous testing to ensure faulty codes do not heavily dampen incoming revenue.

"Early internal and external testing, remediation and retesting are prime indicators to success," the report concluded. "All ICD-10 impacted organizations should act now to allocate as much time as possible for testing and remediation to protect their corporate bottom lines and cash flow to successfully achieve compliance."

More Articles on ICD-10:
ICD-10 Prep Work: Why Hospitals Need to Reach Out to Payers
End-to-End Testing for ICD-10: A Primer for Healthcare Executives
Good Samaritan Begins ICD-10 Implementation a Year Ahead of Deadline

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