ICD-10 Drives Down Hospital Coder Productivity

The ICD-10 transition is negatively impacting inpatient and outpatient coder productivity at hospitals of all sizes and types, according to survey results from healthcare outsourcing vendor HIMagine Solutions Inc.

The company has been collecting data on a weekly basis from a number of its clients since the Oct. 1 ICD-10 compliance date went into effect. What they have found across the board are some pretty steep declines in hospital coder productivity in the month of October compared to ICD-9 AHIMA productivity standards.

According to the data, large academic facilities are seeing an average of 40 percent reduction in inpatient coder productivity while the reduction in outpatient coder productivity ranges from 10-35 percent. Large hospitals (over 250 beds) are seeing a 30-45 percent decline on the inpatient side and a 20-40 percent decrease on the outpatient side.

At the same time, community hospitals (under 250 beds) are experiencing inpatient coder productivity reductions of 22-33 percent while the outpatient side is actually higher ranging between 35-40 percent.

Also See: Worrisome ICD-10 Fallout Seen in Smaller Hospitals

While the decline in coder productivity among hospitals ranges from 10-45 percent as a result of the ICD-10 transition, the vendor notes that “any loss in productivity can ultimately mean a disruption to the revenue cycle.”

Similarly, physician social media network SERMO in a poll last month asked members if the ICD-10 transition was taking their time away from patient care and the response was an overwhelmingly “yes.” Out of nearly 200 responding members, 86 percent said it had impacted patient care while only 14 percent said it had not.

The Medical Group Management Association recommends that providers take a close look at their productivity levels, specifically whether clinicians are seeing fewer patients because they are spending more time on ICD-10 documentation.

But in a HIMagine Solutions survey of 140 HIM leaders conducted prior to the ICD-10 transition, 75 percent of respondents believed that the productivity impact from ICD-10 would be at least 30 percent. Nonetheless, more than a third of those surveyed were not planning on adding incremental resources to address this decline in coder productivity.

“If you’re anticipating this amount of decline, are you just accepting it or are you going to have a strategy to address it?” says Mike Taylor, HIMagine’s chief marketing officer. “Based on the data, a lot of people are looking to computer-assisted coding as sort of a solution to address some of that productivity.”

Although the company’s HIM Benchmark Report found that 56 percent of respondents do not currently utilize computer-assisted coding, 75 percent of those surveyed indicated that they anticipate purchasing CAC technology within the next 12 months. “One thing they definitely aren’t looking at is off-shore coding resources at this point,” adds Taylor.