Prepare for potential ICD-10 shake-ups with careful monitoring, assessment

Why This Topic Matters

It helps practices recognize that stable performance today may not prevent later problems as payer edits, specificity expectations, and reporting requirements tighten. The article is useful for identifying broad areas to watch so organizations can improve revenue-cycle performance and coding accuracy over time.

Article Sections

1. Introduction

   Introduces the ICD-10 environment and the importance of ongoing monitoring as practices adapt to changing payer behavior and operational demands.

2. 5 steps to KPI success

   Outlines a structured approach to tracking performance metrics and using data to support coding and billing oversight.

3. Identify the right metrics

   Discusses choosing practice-relevant measures for billing, revenue cycle, and selected clinical areas based on organizational priorities.

4. Establish a baseline

   Explains the value of historical comparison data and the role of outside sources such as vendors, clearinghouses, and billing services.

5. Analyze the data

   Covers the difference between collecting information and reviewing it for trends, timing, and patterns that may signal issues.

6. Look at the data frequently

   Emphasizes regular review cycles and monitoring around major operational or coding changes.

7. Bring in experienced help, even for the short-term

   Addresses using outside or experienced staff support, chart review, and mentoring to strengthen accuracy and oversight.

8. Take an incremental approach to improvement

   Encourages gradual, multi-pronged improvement efforts that combine audits, analysis, and staff development.