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AS ORGANIZATIONS BEGIN to prepare for ICD-10 implementation, the question of coder productivity is usually close to the top of everyone's list. Addressing productivity in ICD-9-CM will provide a baseline of information crucial for the transition to ICD-10-CM/PCS.
The AHIMA e-HIM Coding Benchmark Workgroup and the 2007 Coding Benchmark Survey have assessed the process of monitoring coding productivity. This article outlines recommended ICD-9- CM productivity standards based on four record types:
* Inpatient
* Ambulatory, outpatient, and interventional surgery and procedures
* Emergency department (ED)
* Ancillary testing
The facilities represented in the survey spanned the entire spectrum of automation. Some facilities were completely paper-based, some used a hybrid record, and others had a high degree of documentation contained in an electronic health record (EHR). Sources of the data from which coders must code affect productivity expectations.
Inpatient Coding
Based on the experience of the workgroup surveyed, coder productivity was about 24 inpatient records per eight-paid-hour day. This figure means coders would spend about 20 minutes per record, finishing three per hour. This productivity expectation may need to be adjusted based on case mix, organizational complexity, acuity, and work assignments other than coding.
Inpatient coding will include a mixture of clinical service types and lengths of stay. Inpatient coding encompasses:
* ICD-9-CM coding for diagnoses and procedures
* Initiation and follow up of physician queries
* Assigning discharge disposition
* Sequencing diagnoses and procedures according to coding guidelines
* Abstracting sufficient data to drop the claim for billing
Factors that facilitate the inpatient coders' ability to achieve optimal productivity include:
* Environment (quiet work area and large/dual screens)
* All data contained in the EHR or limited number of systems that must be accessed to obtain clinical information
*...