title: Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study.
abstract: The Veterans Health Administration (VHA) of the US Department of Veterans Affairs has been preparing for the October 1, 2015, conversion to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) for more than four years. The VHA's Office of Informatics and Analytics ICD-10 Program Management Office established an ICD-10 Learning Lab to explore expected operational challenges. This study was conducted to determine the effects of the classification system conversion on coding productivity. ICD codes are integral to VHA business processes and are used for purposes such as clinical studies, performance measurement, workload capture, cost determination, Veterans Equitable Resource Allocation (VERA) determination, morbidity and mortality classification, indexing of hospital records by disease and operations, data storage and retrieval, research purposes, and reimbursement. The data collection for this study occurred in multiple VHA sites across several months using standardized methods. It is commonly accepted that coding productivity will decrease with the implementation of ICD-10-CM/PCS. The findings of this study suggest that the decrease will be more significant for inpatient coding productivity (64.5 percent productivity decrease) than for ambulatory care coding productivity (6.7 percent productivity decrease). This study reveals the following important points regarding ICD-10-CM/PCS coding productivity: 1. Ambulatory care ICD-10-CM coding productivity is not expected to decrease as significantly as inpatient ICD-10-CM/PCS coding productivity. 2. Coder training and type of record (inpatient versus outpatient) affect coding productivity. 3. Inpatient coding productivity is decreased when a procedure requiring ICD-10-PCS coding is present. It is highly recommended that organizations perform their own analyses to determine the effects of ICD-10-CM/PCS implementation on coding productivity.
authors.affiliation: Shelley Weems, RHIA, CCS, is a health information management specialist in the Veterans Health Administration Office of Informatics and Analytics in Washington, DC.
authors.forename: Shelley
authors.initials: S
authors.lastname: Weems
authors.affiliation: Pamela Heller, RHIA, CCS-P, is the director of health information management in the Veterans Health Administration Office of Informatics and Analytics in Washington, DC.
authors.forename: Pamela
authors.initials: P
authors.lastname: Heller
authors.affiliation: Susan H. Fenton, PhD, RHIA, FAHIMA, is a program specialist in the Veterans Health Administration Office of Informatics and Analytics in Washington, DC.
authors.forename: Susan H
authors.initials: SH
authors.lastname: Fenton
mesh_terms: D000554:Ambulatory Care Facilities; D059019:Clinical Coding / Q000458:organization & administration*; D017598:Efficiency, Organizational; D006801:Humans; D007318:Inservice Training; D038801:International Classification of Diseases / Q000458:organization & administration*; D010865:Pilot Projects; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs
keywords: ICD-10-CM/PCS; coder productivity