Perspect Health Inf Manag - Preparing for ICD-10-CM/PCS implementation: impact on productivity and quality.

Tópicos

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Resumo

Coding productivity is expected to drop significantly during the lead-up to and in the initial stages of ICD-10-CM/PCS implementation, now expected to be delayed until October 1, 2015. This study examined the differences in coding productivity between ICD-9-CM and ICD-10-CM/PCS for hospital inpatient cases matched for complexity and severity. Additionally, interrater reliability was calculated to determine the quality of the coding. On average, coding of an inpatient record took 17.71 minutes (69 percent) longer with ICD-10-CM/PCS than with ICD-9-CM. A two-tailed T-test for statistical validity for independent samples was significant (p = .001). No coder characteristics such as years of experience or educational level were found to be a significant factor in coder productivity. Coders who had received more extensive training were faster than coders who had received only basic training. Though this difference was not statistically significant, it provides a strong indication of significant return on investment for staff training time. Coder interrater reliability was substantial for ICD-9-CM but only moderate for ICD-10-CM/PCS, though some ICD-10-CM/PCS cases had complete interrater (coder) agreement. Time spent coding a case was negatively correlated with interrater reliability (-0.425 for ICD-10-CM and -0.349 for ICD-10-PCS). This finding signals that increased time per case does not necessarily translate to higher quality. Adequate training for coders, as well as guidance regarding time invested per record, is important. Additionally, these findings indicate that previous estimates of initial coder productivity loss with ICD-10-CM/PCS may have been understated.

Resumo Limpo

code product expect drop signific leadup initi stage icdcmpc implement now expect delay octob studi examin differ code product icdcm icdcmpc hospit inpati case match complex sever addit interrat reliabl calcul determin qualiti code averag code inpati record took minut percent longer icdcmpc icdcm twotail ttest statist valid independ sampl signific p coder characterist year experi educ level found signific factor coder product coder receiv extens train faster coder receiv basic train though differ statist signific provid strong indic signific return invest staff train time coder interrat reliabl substanti icdcm moder icdcmpc though icdcmpc case complet interrat coder agreement time spent code case negat correl interrat reliabl icdcm icdpc find signal increas time per case necessarili translat higher qualiti adequ train coder well guidanc regard time invest per record import addit find indic previous estim initi coder product loss icdcmpc may underst

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