Staff training is an essential component of ICD-10 adoption for all medical practices. However, identification of staff members that require intense training is critical to successful remediation. Once key staff has been identified, training methodologies that are comprehensive and rigorous should be in place.
Intense ICD-10 training should occur after introductory training has taken place in your organization. Before beginning more focused training, identified staff should have already been exposed to an introduction of the structural differences between the ICD-9 and ICD-10 code sets, nuances, mapping, and terminology basics. It is important to tailor the more robust training to the type of staff that will be participating. For instance, training for medical coders in an organization will not be the same as training for physicians and mid-level providers. Moreover, training for a clinical documentation improvement program will not mirror training for a case management department. There will be some concepts that overlap; however, training at an intense level is more focused and considers the functions and roles of the staff that is participating.
The first step of intense training development is creation and implementation of a training plan for each identified staff type in your organization. The following displays a sample snapshot of an outline for intense training of endocrinologists in a major health system:
Identifying documentation improvement areas for ICD-10-CM
• Specificity offered with diabetes codes
•Reviewing combination of manifestations and complications within one code found in the Endocrine chapter of ICD-10-CM
• Providing case-studies and using real word de-identified charts to improve documentation in relation to additional conditions impacting a diabetic patient (i.e. hyperglycemic state; ketoacidosis, hyperosmolarity)
• Improved documentation of underlying, drug-relation, and deficiencies related to endocrine diseases and disorders
• Separating specialists into groups and providing four or more case studies of patients with various disorders/diseases and performing real-time documentation gap analysis
• Provide an overview of coding options in relation to diseases and necessary documentation in order to capture the full picture of patient’s severity of illness
In the sample, the initial steps of training allow the physicians to focus on documentation improvement while being exposed to the increased options and changes for ICD-10.
The next step in intense training is to utilize bi-directional feedback as needed during each phase of the intense training program (i.e. quizzes, recaps). Documenting potential trends that can impact the organization from a financial, operational, or administrative perspective is recommended. The key is to involve the identified staff as much as possible while ensuring full comprehension of changes related to ICD-10.
The final step in intense training occurs after the go-live date. A minimum of six months of data should be used to develop more targeted training exercises as needed for the identified staff. Any fluctuations that are identified as trends above or below the desired baseline of an organization should be leveraged to enhance the existing training models for key staff.
MeShawn Foster, MJ, RHIT, is an approved ICD-10-CM/PCS trainer for the American Health Information Management Association.
© 2014 AHIMA, Reprinted with Permission