Central Learning Releases Nationwide ICD-10 Coder Performance Data
Nation’s second open coding contest re-emphasizes the need for continued ICD-10 training and accuracy audits
CENTER VALLEY, P.A. – Sept. 20, 2017 – Central Learning®, a web-based coding assessment and education application, released the results of the 2nd annual nationwide ICD-10 coding accuracy and productivity contest. The announcement was made by Manny Peña, RHIA, Founder and CEO of AVIANCE parent company, Pena4.
Ashley Sparks from San Marcos, Texas and Cynthia Procter from Temple, Texas each received a $2,500 prize for achieving the highest average accuracy scores for their assigned inpatient and outpatient cases respectively. Over 550 coders registered to code 1,636 cases during the August 2017 coding contest. Central Learning automatically scored ICD-10 accuracy and productivity levels using real medical record cases against a vetted, standardized answer key based on published coding guidelines.
Created with feedback from the 1st annual ICD-10 contest, this year’s contest included sample cases for coders to familiarize themselves with the Central Learning application prior to competing. In addition, a video providing step-by-step instructions was made available to all registrants.
“Although a slight improvement in inpatient and emergency department accuracy improvement was realized, the ambulatory surgery accuracy score decreased,” said Peña. “These results demonstrate that the medical coding industry still needs to greatly improve in order to achieve a respectable and acceptable ICD-10 and CPT coding accuracy level. The contest data reflects a true outcome and provides the ability to benchmark data from last year’s contest.”
Contestants coded their cases in Central Learning which simulates a true medical coding environment using real and complete medical records. Codes are entered into a Coding Grouper, just as coders do today in real-life coding.
The following key findings were released today:
- Average inpatient coder accuracy: 61%
- Average outpatient coder accuracy: 41%
- Breakdown—average ambulatory surgery coder accuracy: 45%
- Breakdown—average emergency department coder accuracy: 36%
- DRG Accuracy: 72%, overall financial net impact of -$753.91 per case
- RAC DRG focus accuracy*: 35 %
- Coding productivity per hour: inpatient cases 2.5/outpatient cases 4.8
- Higher productivity decreased coding accuracy by -25.4%
- Higher productivity decreased Outpatient Coding accuracy by -20.3%
Based on Central Learning contest data, the following steps are recommended for HIM directors and coding managers:
- Continue assessing coder knowledge in ICD-10 and CPT coding
- Provide targeted ICD-10 education and training to address knowledge gaps
- Supplement internal coding reviews with monthly external coding audits
- Balance coding productivity and accuracy performance metrics
- Monitor coding denials from payers—predicted increase in 2017 fourth quarter and 2018
Full contest results and more detailed information will be available at Booth #346 at the 2017 AHIMA Convention & Exhibit. In the meantime, learn more at www.centrallearning.com/codingcontest.
* Office of Inspector General Reports Highlight Hospital Billing Issues, MLN Matters Number: SE17017, Initial Article Release Date: September 7, 2017
About Central Learning:
Central Learning is a web-based application that utilizes real medical cases and actual clinical documentation—versus hypothetical coding scenarios and traditional check-the-box tests. Central Learning assesses an organization’s progress with ICD-10 coding quality and productivity without the need for expensive, manual and labor-intensive coding audits. For more information, visit: www.centrallearning.com.
About AVIANCE Suite:
AVIANCE Suite Inc., a company of Pena4, Inc., is an integrated set of web-based software applications designed to help hospitals and health systems make better revenue cycle and clinical coding decisions. With AVIANCE Suite, healthcare finance executives receive real-time business intelligence to build stronger bottom lines and successfully transition to value-based reimbursement. For more information, visit www.aviancesuite.com.