ICD-10 coding competency

lspryszaklspryszak
in CDI Talk Archive
Looking for some help and feedback, so hoping everyone will weigh in.

Are the CDS in your facility required (or expected) to pass an ICD-10 coding competency exam?

Do you feel that this is a realistic expectation for the CDS?

Of course, it's important for the CDS to understand where the query opportunities are so that the most specific I-10 codes can be assigned, but I'm of the opinion that it is not the CDS' job to "assign codes" unless they are certified coders who perform concurrent coding and this is part of their job description.

Thoughts??

Comments

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    Everyone on our team has completed extensive training for ICD-10, with more planned. We were actually all required to achieve a passing score for each module we completed for ICD-10. This is not to say the team is expected to perform 'final' coding that would be suitable for billing.

    The course took about 72 hours, and we have more training for PCS scheduled.

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.412.9421

  • lsipos@monument.healthlsipos@monument.health
    edited April 2016
    We have not been advised that we are going to require to pass a competency exam. We did take classes both online/computer and in-house from a consulting group. For us, the CDI's have actually (in the final processes) created the ICD-10 queries and are currently going to start working on the pdoc (electronic documentation) to ensure the templates the providers use for electronic documentation will have the necessary information from ICD-10 to try and avoid so many queries!

    I feel as you; though we should know and be aware of issues, we are not the coders! We can be educated but I do not code the chart- I support the coding by querying. Live and learn!

    Juli Bovard RN CCDS
    REGIONAL HEALTH
    605-755-8426
    Jbovard@regionalhealth.com

  • lspryszaklspryszak
    edited April 2016
    Paul, thanks for the feedback. I'm not talking about passing scores on I-10 training modules, but in coding actual records.

    Example: the CDS is given an actual redacted medical record and asked to code the record using the I-10 code book -- no encoder or grouper allowed -- with 95% accuracy. All diagnosis and procedure codes expected to be accurately assigned.

    Your thoughts much appreciated.

    Are there any published articles addressing this that you know of?
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    I feel it is very helpful for anyone performing CDI work to at least perform the 'rough' codes in a manner so that an accurate working MS-DRG (and APR-DRG w/ ROM/SOI) can be assigned. The benefits of doing so are self-evident.

    However, this DOES take a significant commitment to training - and, you must use an Encoder to code concurrently.


    I can also advocate that one can perform CDI investigative work sans coding by reviewing a case in order to compliantly pose a query, when warranted. Everyone will seek their own compromise.

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.412.9421

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    Thank for the clarification. Achievement of a 95% score using would be a worthy achievement of a credentialed, highly trained, and very experienced person devoted to coding, only. I personally think this is not a realistic expectation of a CDI team member.

    How many us with the CDIP or the CCDS credential could achieve this score? If we made this mandatory, few in the field with a CDI credential would 'pass' such an examination, in my opinion.




    PE



    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.412.9421

  • lspryszaklspryszak
    Paul,

    Thanks very much. I thought this expectation a little unrealistic, but am so thankful a coding professional validated my random thoughts :)
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    If I could find a coder that can code ICD-10 to 95%, they would have a job on our team. Excellent coders are rare.

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.412.9421

  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    Hahaha! I agree! And not just because excellent coders are rare, but it's also a complex job.

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404


  • cynthia.hudson@christushealth.orgcynthia.hudson@christushealth.org
    edited April 2016
    A doctor on the ACDIS presentation yesterday stated that ICD10 was straightforward and so easy that "my wife could code". I was very surprised at that statement.

    Syndi Hudson, RN, CCM

    CDI Specialist

    Christus Santa Rosa New Braunfels

    600 North Union

    New Braunfels, Texas 78130

    cynthia.hudson@christushealth.org

    830-643-6116 (Office)

    830-643-5139 (Fax)



    "I press on toward the goal to win the prize for which God has called me." Philippians 3:14







  • angelisa.romanelloangelisa.romanello
    edited April 2016
    Paul,
    I agree with you. My goal here continues to be to achieve accurate documentation. We leave the final coding to the coders who are proficient. That being said, our nurses are receiving ICD-10 modules with examinations to complete. I am trying hard to achieve a balance between knowing what information we need documented in the medical record for accurate coding and concurrent queries to assist our final coders on the back end.
    I believe this needs to be a team effort to conquer and utilize ICD-10 to the max.


    Lisa Romanello, RN,BSN,FNS,CCDS
    Manager, Clinical Documentation Improvement
    Quality and Compliance
    CJW Medical Center
    Office phone: 804-228-6527
    Cell phone: 804-629-0396
    AHIMA Approved ICD-10 CM/PCS Trainer
    Angelisa.Romanello@HCAHealthcare.com




  • angelisa.romanelloangelisa.romanello
    edited April 2016
    Especially when they are placed under a timeline of so many charts to be coded in an hour.
    I have a true admiration for our coding partners.
    Lisa


    Lisa Romanello, RN,BSN,FNS,CCDS
    Manager, Clinical Documentation Improvement
    Quality and Compliance
    CJW Medical Center
    Office phone: 804-228-6527
    Cell phone: 804-629-0396
    AHIMA Approved ICD-10 CM/PCS Trainer
    Angelisa.Romanello@HCAHealthcare.com





  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    Lisa,

    I totally agree with your strategy and vision for CDI members...the job is not to final code any chart. Rather, the job, in my opinion, is to recognize if/when a query would be needed regarding an issue that may impact compliance and/or a quality metric.

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.412.9421

    evanspx@sutterhealth.org



  • rmhosler1rmhosler1
    edited April 2016
    We took the precye modules including super user and had to pass at 85% 
    Mary Hosler
    989 891 8072


  • Unknown
    edited April 2016
    I am surprised ACDIS would have a physician representing our organization that has so little respect for the expertise of coders...or his wife!

    Linda

    Linda Haynes, RHIT, CCDS | Manager, Clinical Documentation Improvement | Legacy Health
    19300 SW 65th Ave. | Tualatin, Oregon 97062 | 503-692-8862 | lhaynes@lhs.org


  • tpeytontpeyton
    edited April 2016
    We also did the precyse modules including the super user and had to pass at 85% on each.



    Tracy M Peyton RN, CCDS
    Bradford Regional Medical Center
    Upper Allegany Health Systems
    116 Interstate Parkway
    Bradford, PA 16701





  • michelleclynemichelleclyne
    edited April 2016
    We also did the Precyse modules and had to pass with the same percentage. I understand that we are not coders; however, we need to understand what drives codes and what the coders need to be able to code the chart without delay.

    Thank you,

    Michelle Clyne, RN, MSN/MHA, CCDS
    Clinical Documentation Improvement, Revenue Cycle Services
    Manager for IA, NE & NW
    Conifer Health Solutions
    Catholic Health Initiatives
    10 E. 31st Street, Kearney, NE 68847
    Cell: 308-627-2855 Office Fax: 308-865-2927
    E-mail michelleclyne@catholichealth.net
    Website www.coniferhealth.com


  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    In my opinion it is completely different to be able to pass modules and to be asked to code records. Those two things are not even close to the same thing. I would bet that very few CDI's could pass a I-9 coding exam (otherwise CDI's would likely all be certified coders) so why should they be expected to pass an I-10 one, especially at such a high benchmark. The CCS exam does not even require that high of a %.

    Our team also had onsite training through TrustHCS (though now that was long ago) and had to pass modules. I found that totally reasonable but would never have expected them to be able to code records.

    I agree with everything Paul said and I doubt our coders could pass a I-10 coding test that involved hard coding a record at 95% accuracy.

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    I agree with Katy....forgot who posted the original message, But.....

    My response to mgmt would be that it is not reasonable to expect a CDS to score 95% on a coding exam of any substance...that is not, IMO, a prime function of the role.

    Familiarity is not the same as expertise.



    Paul Evans, RHIA, CCS, CCS-P, CCDS

    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell: 415.412.9421

    evanspx@sutterhealth.org

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    I did not attend that seminar. I am always upset any time anyone makes the statement that 'coding is easy'. Such a sentiment display total ignorance of the skills, background, and education required to be a professional coder. Perhaps this was made in jest? I hope that is the case.



    Paul Evans, RHIA, CCS, CCS-P, CCDS
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