Is ICD-9 and ICD-10 Dual Coding a Recommended Option for Healthcare Providers?

So much talk has been going on about dual coding, that is, using both the ICD-9 and soon-to-be implemented ICD-10 when coding patient records, and often times, these talks echo the distress healthcare institutions and medical coding and billing professionals have, and their unwaning reluctance to the idea of having ICD-10. Citing data from the Health Revenue Assurance Associates (HRAA), EHR Intelligence stated that 72 percent of hospitals are not interested in submitting ICD-10 coded reimbursements to payers for testing prior to the ICD-10 implementation on October 1, 2014. 21 percent are unwilling to code prior the said date, and three-fourths of the hospitals surveyed will only apply dual-coding “sometime” in 2014, which could be a recipe for disaster for some of these institution. As HRAA sees it: “it may be time to dial 911.” Dual coding sounds more work for healthcare providers and their constituents, but if anything, it does seem to increase efficiency and save costs in terms of real-time training and increasing professional preparedness toward ICD-10. Dual-coding supporters like Tennessee-based consultancy, Santa Rosa Consulting promotes the dual coding, stating that it saves companies on training costs (from external providers), increase coder confidence, and help coding directors assess their coders’ readiness level. “Despite the obvious initial loss of productivity during implementation of such a process, a properly executed and well-designed dual coding strategy should be a key component of your organization’s ICD-10 transition program,” the company noted in an article.  How can healthcare providers, top medical billing and coding companies and practitioners know if dual coding is for them? Here are a few things to consider: 1. Do you have ample time before the implementation? Considering that it’s already the end of 2013, we dare say that you may not have a lot of time to train your staff. You know for a fact that there’s no cutting corners when it comes to ICD-10, and unless you and your staff are halfway through your progress, then you need to be on the right track, and fast. As this dual coding tracking monitor data reflects, it takes twice the time to code with ICD-10 than ICD-9. It’s bound to happen of course. 2. How prepared is your staff? Assessing your staff’s preparedness is one important thing to consider when it comes to dual coding implementation. Did they have prior medical billing and coding training for ICD-10 or not? What’s their level of efficiency so far? But if your staff knows what to expect with the ICD-10 implementation from dual coding then the transition will be made much easier. As Santa Rosa Consulting noted, “deer-in-the-headlights moments” can be avoided more effectively. 3. Are you trying to save up on resources? Training from a third-party provider costs a lot no matter what healthcare experts say. Dual coding has the potential to eliminate the need for retraining for ICD-10 or visits from consultants, which, again, costs your organization money. Dual coding provides allied healthcare professionals a firsthand look on what their workload’s going to be when ICD-10 is implemented because they are already working on actual patient charts. It’s practical and real-time training. However, note that your company may still incur costs from dual coding in terms of increased work hours (probably overtime due to initial training) and billing and coding salary. 4. How do your payers and vendors feel about dual coding? A kind of consensus should be reached between you and your vendors before getting your hands dirty with dual coding. As Santa Rosa Consulting suggests, it is important to gauge how much time you need for health information system (HIM) upgrades and revenue reimbursement impact analysis to understand your need to implement dual coding soon. Of course, you have to confirm with your vendors too whether your system or their software can handle dual coding requirements, and if your payers are willing to apply dual coding. ICD-10 has been really a headache for a lot of healthcare providers across the United States. But with ample preparation, enough staff training and streamlined coordination between vendors, payers and healthcare institutions, the load of ICD-10 on everyone can be made lighter. For more information on ICD-10—its disadvantages, benefits, and overall effect on US healthcare—check out our previous blog posts on it: How do I learn about the ICD-10 Coding Changes? The Benefits of Using the New ICD 10 Codes Healthcare’s Big Headache: Is ICD-10 Postponement Prolonging the Pain? ICD-10 Prep on a Budget