Thanks to all our attendees to the IPPS Masterclass this week. We shared a lot of information on the new ICD-10-CM and PCS codes, changes to MS-DRGs and exciting new technologies that were approved for FY27 add-on payments. Educating yourself and your coding team on all the final rule changes ensures you can confidently hit the ground running when you start processing those Oct. 1 discharge and service dates.
Other than being familiar with the impending changes, what else can we do to make sure our coding teams are as prepared as possible? One easy thing to do is to check and make sure your new coding books have been ordered and to watch for delivery updates. A quick Amazon search last week was showing mid to late October deliveries for some publisher’s CM books.
Make sure your coders are aware of the changes and have a procedure in place until their FY27 books arrive. Once the books have arrived, do an update check and make sure the changes are accurately reflected in the publication. It is not unheard of to have printing errors…another crucial reason coders should familiarize themselves on the new changes.
If you have an integrated or standalone encoder, do you know when the updates will be loaded? Will there be any related downtime? Will it be before or after Oct. 1? Will the coding workflow be affected, and if so, how? While these changes may be out of your control, the way you prepare yourself is not.
Some facilities have one designated coder be responsible for either attending an educational webinar or reviewing the final rule and then sharing what they learned with their team. It is vital that each coder on the team is aware of all new changes that have a direct impact on their daily work. This process will look different depending on how big your team is and where they are located. One of the great things about being a coder is the ability to work remotely. Tools such as Microsoft TEAMS and GoToMeeting make this process easier.
If the coders work remotely but are close to a main hospital or other corporate location, they can choose to have an in-person training. In person is always a great idea if it is possible. Getting everyone together, even virtually, is great for team cohesion. Another idea is to include others who might benefit to your education and training. If you know people in other areas of your institution or organization who may perform the coding for other areas or departments, invite them to your sessions.
This can be a great way to develop those relationships within your organization and make your team the “go-to” for questions on coding issues.
Let’s say your team has learned about the new codes and MS-DRG changes, you have verified books and technology updates are ready to go, is there anything else? As part of your review of the changes, are there any that stand out for your facility or group? Does your team do obstetric coding? There are new codes for ectopic pregnancies to consider. Are you seeing the new specificity documented? Is there an opportunity for physician outreach and education? Similarly, we have some new specific secondary malignancy codes for pharynx and larynx. Do you have physicians who routinely document “head and neck mets” without further specificity? Do not wait until mid-October to reach out or send queries. Open those lines of communication now with your providers.
Also, do not assume that everyone knows what you know. I recently saw a handwritten provider note that documented UTI as a diagnosis with an additional notation of 599.0. While that provider was probably trying to be helpful, they missed the memo over a decade ago that we have moved on to ICD-10!
Coders have the opportunity and the obligation to be that expert voice sharing our knowledge and insight with all members of the healthcare team.
