In the June 2016 issue of the Journal of AHIMA, myself and four other industry experts defined new benchmarks and best practices for conducting ICD-10 coding audits.

The move to ICD-10-CM/PCS adds a layer of audit complexity and requirements as hospitals and health systems step up their coding quality review processes, procedures and partners. This article discusses coding audit processes and procedures using the same we had in place for ICD-9:

  • Daily pre-bill second level review of all Medicare cases, hospital-acquired conditions (HACs), and mortalities
  • Third-level risk adjusted clinical review for mortality cases (performed by clinical documentation improvement (CDI) specialists)
  • Review of all PSIs (patient safety indicators) for validation, coding, and clinical opportunities daily by coding and CDI teams.

Read the full article to gain expert insight and advice as new ICD-10 coding patterns and trends emerge.