Clinical coding time: A study on initial productivity Trend in transition of the ICD-10 to ICD-11 morbidity coding in Iran

Background: The International Classification of Diseases 11th revision (ICD-11) serves a wide extent of uses and provides detailed information on the range, causes, and effects of human disease and death through the reported and coded data. Objective: Concerning the ICD-11 classification system, the present study was conducted to implement the ICD-11 and evaluate coding productivity in medical coders following a 1-month training program. Methods: An observational study was conducted in two general hospitals. During the four months from August to November, twelve trained coders coded 1,909 inpatient records. The timing of medical record reading and diagnostic coding with ICD-10 and ICD-11 was documented separately in minutes as a self-report. The trend of coding productivity changes was analyzed to evaluate productivity in the first months of ICD-11 implementation. Results: For record this research, 1475 medical records were included. The overall productivity loss was 42.24 % in the first three months after ICD-11 use. Productivity at the end of the fourth month was slightly better than baseline ICD-10 coding. Trauma cases required more coding time as more details should be coded for post-coordination. Conclusion: Regarding the comprehensive documentation of medical records and the completeness of the details needed for coding with ICD-11 along with the instruction of the principles of ICD-11 coding rules and convention, the time required for coding can be significantly reduced when transitioning to the ICD-11 coding system. It can be hoped that after the four months of training and mentoring the coders, the coding speed will return to the baseline.