BY THE YEAR 2020, new technological advancements are pre- dicted to occur every 30 seconds. 1 This explosion of technology includes the healthcare industry—and with it, clinical coding. The healthcare industry is already witnessing rapid develop- ment of cutting-edge medical procedures using disruptive tech- nologies and processes. Most common in academic medical centers, experimental surgical procedures raise ICD-10-CM/ PCS-related questions for coding professionals and their man- agement teams. Coding professionals often are forced to choose between fully researching complex cases or cutting corners to meet productivity benchmarks. ICD- 10 affords the flexibility to code these complex cases, but
it also requires that coding professionals apply critical thinking
skills and that coding managers adjust productivity expectations.
The Critical Thinking Mindset
According to the World Economic Forum’s report entitled “The
Future of Jobs,” critical thinking is listed as the number two top
skill required in all areas by 2020. Encouraging coding profession-
als to engage their critical thinking skills is paramount when cod-
ing complex cases or new experimental procedures. According to
Critical Thinking Web, a website maintained by Joe Lau, PhD, of
the philosophy department at the University of Hong Kong:
“A critical thinker is able to deduce consequences from what he
knows, and he knows how to make use of information to solve prob-
lems, and to seek relevant sources of information to inform him-
self… Critical thinking can help us acquire knowledge, improve our
theories, and strengthen arguments. We can use critical thinking to
enhance work processes and improve social institutions.” 2
For coding professionals, critical thinking skills must be coupled with a solid grounding in anatomy/physiology and pharmacology. This foundation ensures coding professionals understand the entire clinical picture painted through ancillary
findings and clinical documentation.
Coding professionals also benefit from having an investigator
mentality and the ability to think outside the box when performing research. For example, instead of relying only on “typical” coding resources, a critical thinker may use Google to find a You Tube
video of a new procedure and go to the manufacturer’s website for
any recommended codes suggested for the device or procedure.
Empowering Critical Thinkers
How can a coding manager identify coding professionals who
possess critical thinking skills and encourage their development? The best way is to use a different coding exam—one that
includes several new procedures not already explained in the
coding book. Coders who aren’t afraid to ask for clarification
are usually the best candidates, especially if they seek input via
thoughtful and referenced questions.
Generally speaking, coding candidates who don’t ask for clarification tend to be more focused on productivity rather than accuracy.
They tend to forego the time needed to perform research or ask
questions. While the lack of questions may be an attempt to appear
knowledgeable, it does not suggest a strong critical thinking mindset.
Consider the following strategies to encourage a critical thinking mindset among coding teams:
Foster an environment of curiosity, learning, and sharing. Staff
should feel comfortable asking questions with impunity.
Tackling Tough Cases: How to
Empower Critical Thinking and
Temper Productivity Goals
By Sarah Humbert, RHIA