ICD-10 metrics: Which numbers you need to track

Conventional wisdom says medical coder productivity is going to drop 40 percent after ICD-10 implementation. Maybe. This certainly seems to be a case where your mileage may vary.

The only way you're going to know that is if you start tracking key metrics now to make sure you have some sort of baseline. You have to start measuring something such as charts coded in a day and coding accuracy. Ken Bradley, vice president of strategic planning at Navicure, has some very good suggestions for which numbers your practice should track while preparing for ICD-10 implementation. He starts with medical coding productivity which can be captured by measuring:

  • How long it takes a coder to correctly code a claim.
  • How fast a claim gets out the door to the payer.
  • How quickly you can get payers to answer your coding questions.

[See also: Why you need metrics before you can boost medical coding productivity]

Monitoring productivity is good. But it's not the only thing you need to be watching. Cash flow is even more important, and some issues can delay or halt reimbursements. There is the potential to repeat the reimbursement problems experienced during the HIPAA 5010 transition.

[See also: HIPAA 5010: CMS explains why medical claims are rejected]

You need to know if there's a problem first. That's why Bradley also suggests that medical practices track:

  • Days in accounts receivable by healthcare payer.
  • Denial rates.
  • Amount of reimbursements denied.
  • If reimbursements match the contracted rates.

As with productivity, you need to know what's "normal." That means now. Otherwise, if you wait for Oct. 1, 2014, you won't know if the numbers reveal problems or business as usual. Bradley also suggests crunching these numbers weekly to keep small problems from becoming big ones at the end of the month.

And who knows…maybe tracking these metrics will reveal problems unrelated to ICD-10 coding that you could solve sooner than later.