How Trending Reports Benefit Inpatient Medical Coding Compliance Audits

Wouldn’t you want to have a crystal ball when it comes to decision making? Trending reports, unfortunately won’t tell you the future. But, when based on accurate historical data, trending reports will provide future insights. This allows you to identify promising (as well as problematic) performance areas.

Anticipating coding quality strengths and weaknesses is a great benefit trending reports offer when it comes to coding compliance audits. “Trending reports allow decision makers to identify patterns that can benefit or harm the performance analyzed. This allows teams to gain future value from historical data projections,” says Mari E. Cely, Director of Business Strategy and Client Services.

By taking advantage of trending analysis, a coding team can remain accurate and competitive in today’s health information management (HIM) industry.

Leveraging your trending data will allow you to:

  • Identify areas of strengths among your coding staff in order to duplicate their successes
  • Flag potential opportunities for improvement where currently underperforming
  • Predict long-term performance and assist in decision making
  • Evaluate effectiveness of managerial decisions with potential corrective action

Examples of the Benefits of Trending Reports

MS-DRG change trends can assist with identification of specific DRG complexities where additional training or education may be needed.

In trending ICD-10-CM diagnosis accuracy rates, we assisted the client in identification of some coders’ lack of assigning applicable HCC diagnosis coding. We re-educated these coders regarding the significance of HCC diagnosis code assignments.

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For a 4Q audit, the ICD-10-CM diagnosis and ICD-10-PCS procedure accuracy rates declined overall. With trending reports, we identified that the coders were miscoding several diagnoses and procedures that were new 10/1 codes. We provided additional education on the 10/1 updates and their accuracy rates increased for the 1Q audit of the following year. We also provided 10/1 update education the following year. And we did a comparison trending report for the next 4Q to ensure that the coders comprehended the additional 10/1 code update education.

Benefits of Trending Dashboards

Trending dashboards can be used to tap into the primal competitiveness in us all. Providing de-identified versions of the report outlining “Top Performers” allows staff to evaluate and compare where their accuracy rates fall in relation to their peers. It is important to note these tools are not designed to be punitive in nature. Rather, they are to provide each coder a confidential report on where they stand among their peers.

“Allowing team members to easily and confidentially compare their performance against their peers’ performance oftentimes establishes a healthy competitive culture, resulting in increased performance throughout entire teams,” says JJ Crumbley, Director of Operations and Project Management.

In addition to identifying these Top Performers, these reports allow managers to provide monthly/quarterly feedback to them. With the dashboards, managers can utilize the reports to provide year-round recognition to the Top Performers, instead of just at evaluation time. As managers, it is important to recognize in an email or verbally that these high producers are doing a “good job.” The recognition of their work also assists in retaining Top Performers.

Additional Resources

For more information on the benefits of medical coding audits and trending reports, review these articles:

Experience the benefits of trending reports for your organization and contact YES HIM Consulting’s team of experts to schedule an audit. Review the full scope of our auditing services here.

Mari Cely

Director, Business Strategy & Marketing
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