1. Coding Productivity Assessment Post ICD10 Implementation
May 9, 2016

2. Franciscan Alliance 14 acute care hospitals, 4 regions
Indiana and Illinois
68 coders- 23 IP/45 OP
54.9 coder FTE’s
32 coding support/coding leadership staff
Electronic Medical Record IP/OP- EPIC
Scanned images – HPF (primarily OP surgery center and clinics)
Billing- EPIC
Clinical Documentation Improvement- 3M CDIS
Prior to CAC- 3M CRS only
Use CAC for Acute Inpatient (excluding mom/babes)

3. Corporate Coding Structure
Manager/Supervisors
Support staff:
Auditors, Educators, Analysts
Coding staff:
Reimbursement Specialists, Coders HT

4. Pre-Productivity Study Checklist:
Standardize coding workflows
Regional variation was standardized whenever possible
Nontraditional coding tasks were removed
Discuss barriers that negatively impact productivity with coding staff
Examples -orders not in standard location, system slowness HT

5. Pre-Productivity Study Checklist:
Identify timeframe for productivity study
Consider staffing and any unusual workload changes
Select a time that workload is “normal”
Develop productivity report
Ensure it includes all data elements necessary to calculate productivity
Validate it is pulling accurate data
Develop nonproductive log
Include only unusual items that are NOT part of the normal workflow
Train staff on how to complete nonproductive logs and track coding time DM

6. Nonproductive Log Template

7. Key for Nonproductive Log Tracking

8. Post-Productivity Study Checklist
Analyze results
Identify average productivity by comparing all coders results
Look for errors in tracking (higher or lower than possible)
Compare results to national trends DM

9. How Information Was Analyzed

10. How Information Was Analyzed

11. National Productivity Trends Based on ICD-9

12. Post-Productivity Study Checklist:
Set temporary standards
Compare workload to results to see if workload can be maintained with new standards
Determine timeline to begin holding staff accountable
Review results with staff and set expectations
Assist staff with meeting new standards
Identify high performers that can demonstrate workflow for rest of staff
Review barriers DM

13. Post-Productivity Study Checklist:
Provide coders with productivity results every two weeks for the first 2 months
Hold staff accountable beginning with 3rd month
Establish long term goal for final standards
Reassess productivity
Approximately 6 months after initial study HT

14. Questions????
Dawn Matheson, RHIA Corporate Coding Manager- Specialty Heather Taillon, RHIA Corporate Coding Director