Health Systems Management Network, Inc Announces to Clients that Implementation of ICD10-CM Must Begin with an Audit of Clinical Documentation Practices and Coding Many of Health Systems Management Network’s (HSMN) clients have asked what systems they should buy to transition to the ICD-10-CM /PCS coding in 2014. HSMN’s answer and one that has been given over a period of 30 years is “It’s the clinical documentation Mr. CFO”. Every hospital’s clinical staff, and particularly individual clinical disciplines, has their own cultures, traditions and clinical training which often are at odds with clinical documentation requirements. The clinical mind, the one bringing together all of the clinical data that makes clinical decisions is the number one computer that matters. HSMN advises its client hospitals and their medical staffs to audit their own clinical documentation practices because the best set of specifications for whatever systems are going to be introduced to the hospital are the ones determined by clinical practice. How does the CFO or CEO get an entire staff to agree on a system? HSMN’s experience has been to collect the clinical practice documentation from every clinical department and do an audit of both the clinical documentation and the final claim in order to determine how close the supporting documentation matched the final claim discharge diagnosis and the basis for payment. The first part of this exercise tells the organization how well they are doing or not doing under the current ICD-9-CM with specificity and accuracy through parsing and documentation deconstruction. The second phase is to reconstruct active cases into ICD-10-CM. These exercises engage the medical staff in looking at how they practice, how they document and how well they will do under ICD-10-CM. In some hospitals a performance metric is assigned by the clinical department to see how many of a clinicians encounters are denied or rejected on both the hospital and professional fee side. Hospitals tell HSMN that they have already invested a great deal of money in coder training and systems and are cynical about doing more. HSMN has been very successful in working with the medical staff who are the key to success in the new coding environment.
It must be mentioned that the exercises described above involve partnering with the coding staff who have much to learn about the content of clinical practice. HSMN is well known in the industry for pioneering “Role Modeling” for these exercises, which are then transferred to the hospital and its staff. “There is no black box that can fix poor clinical documentation practices. Improvements have to be internalized and champions on the medical staff or practice leaders must take ownership of this process on a continuing basis” says Theo Tarantini of HSMN. They urge potential customers to call them so that they can share the ways in which they have helped many client hospitals and practices improve their clinical documentation and coding. Please contact our offices by calling 866-908-4226 or email firstname.lastname@example.org for a consultation on how HSMN can be of service to your organization. This initial teleconference consultation is without cost. To know more visit http://www.hsmn.com