Central Learning's national 2016 ICD-10 coding contest highlighted the converse relationship between coding accuracy and productivity across inpatient, ambulatory and emergency settings.
Central Learning is a web-based coding assessment application, belonging to AVIANCE's suite of health information and revenue cycle management solutions.
More than 550 coders registered with Central Learning to code 1,859 cases in September. The website scored ICD-10 coding accuracy and productivity levels using medical record cases against a vetted, standardized answer key based on published coding guidelines.
Contestants were given official coding guidelines per patient type: inpatient, ambulatory surgery and emergency. Winners for each patient type were determined by calculating the highest average accuracy scores for their assigned cases.
Here are five findings.
1. Average inpatient coder accuracy: 55 percent.
2. Average ambulatory surgery coder accuracy: 46 percent.
3. Average emergency department coder accuracy: 33 percent.
4. Researchers found a converse relationship between productivity and accuracy. For instance, coders with high productivity levels scored lower in ICD-10 coding accuracy during the contest.
5. Emergency department coders did not consistently assign external cause codes, even though the information was available in the records and contest guidelines.
Based on contest data, Central Learning recommended the following steps for HIM directors and coding managers.
- Continue assessing coder knowledge in ICD-10.
- Provide targeted ICD-10 education and training to address knowledge gaps.
- Supplement internal coding reviews with monthly external coding audits.
- Balance coding productivity and accuracy performance metrics.
- Monitor coding denials from payers as they are predicted to increase in 2017.