An annual coding contest revealed that the accuracy of outpatient coding worsened in 2019, ICD-10 Monitor reports.
Five insights:
1. Central Learning’s annual coding contest found accuracy rates of 38 percent in 2016, 41 percent in 2017, 42.5 percent in 2018 and 40.4 percent in 2019.
2. The 2019 contest focused on outpatient coding due to significant increases in outpatient services and shifts in payment methodologies.
3. Contestants in 2019 coded more than 4,000 cases, with an accuracy rate of 60.5 percent for primary diagnoses and just 38.6 percent for secondary diagnoses.
4. A lack of specificity was an issue among primary diagnosis codes, and codes for secondary diagnoses failed to follow coding principles and guidelines.
5. ICD-10 Monitor‘s Holly Louise, BSN, RN, said the inaccuracies could indicate that production benchmarks are too high, coding tools are antiquated or overly scaled down, or coders rely too heavily on technology.
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Photo courtesy of: Becker’s ASC
Originally Published On: Becker’s ASC
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The above discusses diagnoses but procedure unbundling is just as bad. The coders don’t read the procedure narrative and hence code from the procedure title.
Part of this problem is the offshore coding because those folks have about 4 minutes to code a chart. The folks who own offshore undercharge facilities/providers for each chart coded. They make their profits on volume. ka-ching! Hence, the high production quotas. Therefore, in order to maintain volume, the coders bypass all edits in the system in order to maintain production quotas. It’s like working in the mills of the 1900’s with air condition.
Any annual updates the coders have to learn on their own not company time. And no such thing as in-services in the offshore market.
You get what you paid for!
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