Make sure your ICD-10 training program leaves room for coders to become comfortable actually using the ICD-10-CM/PCS codes. The final rule implementing ICD-10-CM and ICD-10-PCS identifies the need for 50 hours of training to learn the ICD-10-CM and ICD-10-PCS systems. This is for inpatient coders, assuming they are already familiar with the general conventions of ICD and they already have the prerequisite knowledge of the biomedical sciences (such as anatomy and physiology). That seems like a lot of time, but when you break it down it can be quickly consumed in learning the fundamentals of the new code sets. And in fact, most healthcare provider organizations are spending much greater amounts of time.

The predominant training programs available (online and in person) include anywhere from 40 to 70 hours in a formal, systematic progression through the ICD-10-CM and ICD-10-PCS code sets and their associated official coding guidelines. Of course coding professionals need a thorough training on the fundamentals of ICD-10-CM and ICD-10-PCS. That’s an absolute must. But really, the only way a coder learns to actually code, is by, well … coding. In developing your coder ICD-10 training plan, be sure to leave a cushion of time after formal training, before ICD-10 go live, for the coders to practice applying codes to real health records. They need to practice what they’ve learned and build confidence, preferably before go live, to minimize operational disruptions.

A couple suggestions:

• Provide case scenarios from your hospital for practice coding. These should be fully coded in ICD-10-CM/PCS so you can follow up with answer keys and coding rationale.
• If time is a constraint, have your inpatient coders practice simply assigning root operations to inpatient cases for practice in applying ICD-10-PCS root operation definitions. Again, you will need an answer key to ensure they are building accurate skills.
• Provide regular checks for understanding to objectively assess progress, this could be in the form of multiple choice questions on important concepts.

The key is regular, repeated practice applying the new codes and guidelines, with accurate, consistent and timely feedback so the coders gain confidence.

If you don’t leave room for this in your plan (I recommend a minimum of 3 months), how will you know if your coders are really ready?

Mary H. Stanfill - Vice President of Health Information Management Services

January 30, 2012