Question

What is the high-level objective and define the goal for Proper ICD-10 coding? Explain “fitness for use” as it relates to proper ICD-10 coding objective. Discuss BOTH bottom-up AND top-down approaches to establish a plan and metrics for the proper ICD-10 coding.

Answer 1

High-level objectives have related to the strategic category. ICD 10 has a high-level objective based on physician documentation. It is based on coding staff, auditors, educators, and coding management.
The goal for ICD 10 coding includes

-Anatomy and physiology training for coders to make sure code level for ICD 10
-Traning for the physician on documentation
-Talk with software vendors about ICD-10 transition plans for necessary purchases for the coming years.
-Talk with commercial payers about transition plans whether they plan for any policy changes and payments and process of reimbursement etc.
-Make a plan for workers comp and auto insurance.
-find out the policy and procedures that affected by ICD 10 to provide the advance beneficiary notification.
-follow the diagnosis code and never miss the codes that will be affected and follow day in the life of diagnosis code at the organization.
Fitness for use has to meet the requirement at the analysis phase. real purpose and request should fir for purpose. correct use of coding evaluated to determine the use of the software. the software can be used for the functional requirements to evaluate fitness for use.
coding quality plays an important role in reducing costs and protecting revenue. Health information management leaders should reevaluate coding programs for rapid improvement to improve accuracy by considering consistency, colloboration, and education. Incorrect coding results in denial and recoupments, it results in reimbursement delay and cost increase.
consistency makes coding quality. commitment with coding policies, procedures, and practice make coding quality, it should follow the compliance guidelines and communicate with all staffs and special knowledge of facility-specific practice can create quality coding.
colloboration prevents coding denial, when we engage with the management team it avoids miscoded records. the team must make a consistent process for finding out denial monitoring and research.
education makes accurate coding, training process explain the coding process for coders. fully integrate with practice to improve knowledge is important. training should focus on proper topics, service line issues, and specific modality. the coding training program should share the coding quality plan for making sure the accuracy and understanding.
encourage coders for an open forum to ask any doubts and questions without fear. Have concentrate on productivity, coding time should be calculated by the coding managers for recent graduate coders, professional coders experienced inpatient coders and contract partners.