Title

Increasing the Accuracy of ICD-10 Codes to Support Hospital Based Laboratory Testing Ordered by Outreach Clients

Document Type

Presentation

Publication Date

11-18-2016

Comments

Advisor:

MR Cooper, Jefferson College of Population Health Thomas Jefferson University

Abstract

The objective of this research is to determine the effectiveness of an ICD-10 code informational packet to increase the accuracy of ICD-10 codes submitted by healthcare providers to support the laboratory tests requested. During a recent LEAN project, the pre-analytical laboratory staff members noted a significant amount of “rework” associated with obtaining appropriate ICD-10 codes to support certain laboratory tests: thyroid stimulating hormone (TSH), vitamin D, lipid panel, hemoglobin A1C (A1C) and ferritin/iron. Additionally, many providers were ordering these tests utilizing only the preventative exam, no abnormalities ICD-10 code of Z00.00. Approximately 700 patients’ samples per month required follow-up with the ordering provider to obtain ICD-10 codes to support laboratory testing. The research design was conceptualized based on an interventional study and incorporated the Plan-Do-Study-Act (PDSA) model. Outreach client physician practices were selected for a telephone survey to assess the usefulness of an ICD-10 code educational intervention. The educational intervention included the most commonly used ICD-10 codes by internal medicine physicians, and a listing of ICD-10 code websites with links which included CMS (Centers for Medicare and Medicaid Services), CDC (Centers for Disease Control and Prevention) and AHIMA (American Health Information Management Association). One practice was selected as the pilot site based on a consistently high incidence of incomplete ICD-10 codes provided for laboratory tests requested. Data collected included the number of requisitions submitted, and the number of incomplete ICD-10 codes for specific laboratory tests ordered. Data elements were collected pre and post the intervention and showed minimal improvement in the accuracy of ICD-10 codes provided. However, there were barriers beyond the control of the study which affected the outcomes.

Presentation: 20:55