All is Not Well in the Small Hospital World When It Comes to the ICD-10 Transition

By Nitin Thakor, GeBBS President & CEO

So far small hospitals and small health systems are not faring as well as large hospitals and health systems during the ICD-10 transition. The press is full of reports about how well the transition is going for large hospitals, but that is not the case for smaller community hospitals.

ICD-10 Training

There are several reasons for this.  Many smaller hospitals were not as well prepared as the large hospitals. They just didn’t have the budget to conduct intensive preparation campaigns. Also, the lack of clinical documentation improvements (CDI) by their physicians seems to be an issue, and for some their greatest challenge.

Many physicians have taken little or no advantage of ICD-10 training. This has led to a lack of knowledge on the documentation of procedures and diagnoses to meet the specificity requirements of ICD-10.

An even more common problem seems to be that many small hospitals, typically under 300 beds, have offered very little training to their physicians, either because of opposition by hospital physician staff, or ICD-10 transition teams did not understand the importance of upgraded documentation.

These small hospitals are working hard to catch up by adopting programs to help them meet the challenges of ICD-10.  In getting a late start to cope with ICD-10, many small hospitals are considering using an outsourcing medical coding and outsourcing medical billing partner, who has been diligently preparing for the ICD-10 transition for several years. An experienced outsourcing partner can provide immediate expertise to ensure small hospitals’ revenue risks are minimized.

Working with a knowledgeable outsource partner can also reduce costs and overhead complexity. Expertise is available and there is no need to face the transition alone. Select an outsourcing partner on the basis of their coding and billing experience and knowledge. All of their coders will have undergone a stringent screening process to verify their skill level, education, experience, and level of professionalism. Most will be certified RHIT, RHIA, CCS, CCS-P, CPC or CPC-H.

An outsourcing partner can also provide targeted training programs to help physicians with CDI and to help hospitals retain their most experienced medical coders – those who will be the most valuable during the next year or so of the ICD-10 transition.

Finally, small hospitals need to take advantage of new technology that has dramatically changed the medical coding process within health information management.  Computer-assisted coding or CAC is a cutting edge technology that automatically derives medical codes within clinical documentation. CAC technology is an enterprise-wide coding solution that improves and enhances the overall coding process. It combines expert workflow technologies, rules-based automation, and certified coders to guarantee accuracy rates of over 95%.

Getting a late start does not mean you cannot win the ICD-10 race; it just means you have to work a little harder and smarter!