Road Map to ICD-10-CM: Mapping Training

By Deborah Grider, CPC-E/M, CPC-H, CPC-P, CCS-P

Training is critical to the success of your ICD-10-CM implementation plan. Development and implementation of a training plan can take two or more years. You may think preparing an education plan for
ICD-10-CM will be easy, but think about the impact to your practice. You must have the buy in from your organization or practice. Some recommended steps include the following:

Assess Baseline Knowledge

The first step in developing a training program is to assess your baseline knowledge of anatomy, physiology, pharmacology (medications), and medical terminology as it’s important to have a good understanding of terminology and anatomy when using ICD-10-CM. Keep in mind ICD-10-CM has a higher level of detail than ICD-9-CM. If finding time away from the office is a problem, there are many resources on the internet to test skill sets including some free websites that allow the user to review medical terminology and anatomy along with short tests to assess your understanding. The University of Minnesota has a free website for testing anatomy. This website can be found at: http://msjensen.cehd.umn.edu/webanatomy. There are other websites, such as “University Class” which charge an affordable fee for the courses.  In fact, there are over 900,000 sites online for anatomy and terminology. Here are just a few you might find helpful:

www.corexcel.com/html/online.medical.terminology.htm

/www.expertrating.com/awareness-tests/Anatomy-Terminology-Certification.asp

www.becomehealthynow.com/article/bodycell/709/2/

www.ritecode.com/

The AAPC has several on-line courses for anatomy, terminology, pathophysiology, and pharmacology which will help you prepare for ICD-10-CM. You can access the information on the AAPC website at: www.aapc.com.

Training Objectives

Once you have tested your skill in the areas of terminology and anatomy, and taken a refresher course if needed, it’s time to prepare for ICD-10-CM. The second step in this process is to map out your training objectives by reviewing the specific skill sets your practice will need. Map out a time line for completion of this step. You might work in a family practice environment where a full course on ICD-10-CM would benefit the practice. If you work in a sub-specialty practice, such as ophthalmology or orthopedics, you might want to focus on the specific diagnosis code sets for your specialty.

Which Training Media Will You Use?

You may benefit by taking a self-study training module on ICD-10-CM guidelines, which includes a self test at the end of the module or you may want to attend a workshop, seminar, or course on ICD-10-CM. There are many ICD-10-CM courses available right now and many more to come throughout 2008. What about a classroom? If you work in primary care or a specialty that typically uses many diagnosis codes in your practice, a classroom, seminar or online course might be more beneficial. You also may consider a combination of e-learning, self-study and classroom to accomplish your goal.

Identify Training Sources

How will you accomplish the training if you decide to undertake a classroom model or seminar?  Will you conduct the training internally? Is there someone in your practice or organization who is ICD-10-CM coding savvy? If you don’t have the time to prepare and deliver training, consider external sources. You can contract with an instructor, consultant, or other organization who can train over a specified period of time. Seminars are also good adjunctive training options; however, you can’t really learn ICD-10-CM in one day.

Develop a Training Budget

Develop your training budget once you determine the method(s) of learning required. Make sure you budget for training managers, clinical staff non-physician providers, managers, front office staff, ancillary staff, and physicians. Everyone needs training on some level.

Provide Training

Begin the training process in your practice. Don’t wait until the last minute. Remember HIPAA? Was your practice prepared well in advance or did you wait until the month before implementation to prepare? Allow a minimum of a year to complete training for your entire group.

Determine who needs training in your organization. Be aware that the front office staff, managers, clinical and ancillary staff may not need the extensive training the physicians, non-physician providers, coders and billers need. The front office staff, managers, clinical and ancillary staff might need four to six hours of training. A seminar or e-learning environment related to your specialty might be a good avenue. A generic seminar has little benefit while a seminar to review ICD-10-CM guidelines is fine. Ultimately, it’s recommended to attend a specialty specific session to help you understand the ICD-10-CM chapters you’ll use daily in your practice or organization as well as a ICD-10-CM guidelines review seminar.

For physicians, coders and non-physician practitioners, it’s a good idea to participate in a full course, or have an instructor (internal or external) plan a curriculum over several months to cover all avenues of ICD-10-CM coding. Use real case studies from the medical record so training makes sense to the providers and coders. Even if you outsource the coding and have an instructor provide training in-house, provide them with copies of your notes to use in their training hand out. A post-test is helpful to determine if the participant understands ICD-10-CM coding concepts.

For those who will use ICD-10-CM on a day-to-day basis, providing all the training in one day usually isn’t a good idea as the information isn’t retained for a long period of time. Keep in mind that documentation issues should be addressed in provider training.

Formulate a training schedule. One year prior to ICD-10-CM implementation, you might prepare by focusing on e-learning, audio conferences and seminars. Four to six months prior to implementation, reinforce the importance of detailed documentation in ICD-10-CM as the training should be more in-depth so everyone has a good understanding.

Measure Productivity

One way to measure productivity is to have the coders and/or providers begin using ICD-10-CM along with ICD-9-CM. Using both will assist with the evaluation of documentation deficiencies and also the time it takes to code with ICD-10-CM.  There is usually a learning curve and productivity might be compromised for a short period of time. With diligence, the coders and providers will become comfortable with ICD-10-CM and gradually productivity will increase.

Did Training Accomplish Your Objective?

Have the coders and providers developed a level of proficiency. One way to measure training success is to perform an audit of your ICD-10-CM coded medical records. Another way is to provide a test a few weeks after training to measure retention. Both methods are helpful in identifying weaknesses in coding and/or documentation that can be corrected prior to “Go Live” with ICD-10-CM.

Outcomes Measurement

One month prior to implementation measure the coders and providers understanding of ICD-10-CM, and then provide customized learning to fill knowledge gaps. This is a good time to formulate new policies and procedures as part of your compliance plan. Communication is the best way to make sure everyone in your organization is comfortable with ICD-10-CM.

Training Ensures Success

Training is a vital part of ensuring your success with ICD-10-CM. Having a training committee to develop a schedule and plan of action benefits the entire organization. Next … Determining payer and system readiness.

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