Chart Lab: coding practice on practice charts

What it is

Chart Lab is practice for medical coders, inside Live Practice. Your coder reads a patient chart written from your coding guideline and codes it the way they do at work. Nothing is spoken: they type the codes. Every code is marked against an answer key a person at your company approved, code by code, the way a quality audit marks a chart.

Today Chart Lab is diagnosis coding: ICD-10-CM, the FY2027 code set. Every code in an answer key is checked against the official code list and must be a complete, billable code in it, and the descriptions your coders see come from that list.

Two ways to practise

• Code the chart. Your coder reads the chart and enters the codes: the principal or first-listed code first, then the secondary codes. It is scored code by code, like a quality audit.
• Audit the AI. Each chart comes with AI-suggested codes with planted errors: a wrong 7th character, the right category but the wrong code, a missing or an extra code, a secondary code put first. Your coder accepts, changes or deletes each line and adds any code that is missing. Some charts are fully right, so accepting everything never pays.

The errors are planted from the approved key, so you can see every one of them, and the right action for it, before anyone takes the practice.

Setting one up

1. 1

   Choose Chart Lab

   In Live Practice, press New practice and choose Chart Lab.

2. 2

   Choose the guideline

   Pick One of your courses, or Upload or paste the coding guideline the charts test: your client’s conventions, with their rules and examples. Every chart is written from it.

3. 3

   Choose the mode and setting

   Choose Code the chart or Audit the AI, and the Setting: Inpatient, Outpatient, Emergency department or Risk adjustment.

4. 4

   Write the charts

   Press Write the charts. Four charts are written in a minute or two: each answer key first, then a chart that supports exactly that key. Every key code is checked against the official code list, and a second coding reads each chart without the key.

5. 5

   Approve each chart

   Read every chart and its key, and approve the ones that are right (below). Only approved charts are ever given to your people.

6. 6

   Choose who takes it, and put it live

   Under Who takes it, and how, choose the roles (or everyone), what your people do, the setting, about how long it takes, the pass mark, which sessions a manager reviews and how many days people have to practise. Then press Save and put live; it needs at least one approved chart.

Checking and approving each chart

Under The charts, each chart is marked To check, Approved or Retired. Open one to read the chart beside its key: each code with its role, the Evidence in the chart (the chart’s own words behind the code, word for word; press them to see them marked in the chart) and Why. In Audit the AI you also see the suggested codes your people will check, each planted error and its right action.

Where the second coding read the chart differently, it says Check this: a code it added that is not in the key, a key code it left out, or a different principal. It never changes the key; you decide. To keep the key and still hear about it, tick Keep the key, and send a learner who codes it this way to a manager. Then press Approve this chart.

• Edit the key changes a code, its role, its evidence or why. Every code is checked against the code list and every piece of evidence against the chart, and saving puts the chart back to To check until you approve it again.
• Once anybody has coded a chart, its key is fixed. Retire and edit a copy makes a new draft with the same chart and key for you to change; Retire takes a chart out for good. Results that used it keep it as it was.
• Write more cases writes more charts, as many as you choose, for the setting you choose.
• A session gives each person up to three approved charts, the ones they have done least.

No real patient in the charts

The charts are made up for practice and carry no names, dates or record numbers: days are counted (“Day 0”, “hospital day 3”) and no place is smaller than a state. Each chart is screened for patient details as it is written, and one that has any is dropped. Above every chart your coders see Made up for practice. No real patient.

What your coder sees

1. 1

   The briefing

   Signed in with their employee number and PIN, they open the practice from their home screen. The briefing says what they do, the setting, the code set and how many charts there are. They press Start coding; no microphone is needed.

2. 2

   The chart

   The chart is on the left, in its sections, at a size made for reading. On a phone it comes first, with the coding under it.

3. 3

   Their codes

   Under Your codes they type one code a line: the principal or first-listed code first, then the secondary codes in any order. Under every code its description appears from the official code list, or Not a code, or Needs more characters for a code that is not complete. In Audit the AI they Accept, Change or Delete each suggested line, can Make principal another line, and Add a missing code.

4. 4

   Submit

   They press Submit this chart and see how they did straight away, then Next chart, and after the last one Finish and see my result.

Coding is done in English, so the Chart Lab screens are in English whatever language a person reads.

The scorecard

After each chart, How you did on this chart shows four figures. The session’s mark is the average of its charts’ scores, against your pass mark.

• Score: every code against the key, with the principal code counting twice.
• Per code: the codes right, out of the codes entered or the codes in the key, whichever is more. A code in the right category, or wrong only in its 7th character, counts half.
• Clean record: yes only when every code is right, nothing is missing or extra, and the principal is first.
• Principal first: whether their first code is the key’s principal.

In Audit the AI it also shows Errors caught out of those planted, and Right lines you changed or deleted. Below, Code by code lists every line as Right, Partly right, Wrong, Not a valid code, Missing or Not in the key, with their code beside the key’s and Why. Show in the chart marks the words in the chart behind the code.

Reviews and the report

Every Chart Lab practice has a Sessions tab, and sessions waiting for a manager are listed under Waiting for you on Live Practice. A session is sent for review when the coder coded a chart the way a Check this you kept warned of, or sent their result to their manager. Choose Every chart under A manager reviews to review them all. Open a session to see each chart, the coder’s codes against the key and the chart itself, and change the score with a note for the record.

Chart Lab sessions count in the Live Practice report the way calls do: who has practised, the pass rate, who is struggling, who has not started and who is past their practise-by date.