Thoughts from a NACRS coder on CIHI’s latest course about strokes

Thoughts from a NACRS coder on CIHI’s latest course about strokes

CIHI’s new learning bundle, 5003E – Different Strokes Need Different Codes, builds on their previous course on coding strokes (309 – Different Codes for Different Strokes). It focuses on limiting the use of the code I64 Stroke, not specified as haemorrhage or infarction, and instead encourages coders to choose the most accurate and specific code whenever possible.

The course includes three levels—basic, intermediate, and complex—and walks users through case studies to build skills and confidence while assigning stroke codes. Three CHIMA members took the course and were happy to share their feedback with us.


Joanne Ballantyne, CHIM, CCCS is primarily an NACRS coder, but has also done DAD and oncology coding. She will be returning to DAD coding following her maternity leave.

Did you find the course description and objectives clear?

Upon review of the CIHI stroke course, all of the objectives were clear on what needed to be completed for the course. I did realize after reading the first module discharge abstract that I was supposed to click on all of the items that were helpful, as I only clicked one and then hit the next button. I was able to figure out that I was able to click more than one area on the document so continued on this throughout the rest of the modules.

Of the three courses in the bundle, which ones did you complete?

I completed all of the stroke courses in the bundle, as I find coding strokes very interesting and always like to review and keep up to date with the coding of strokes. Sometime strokes are very hard to code and to get the understanding of. I found this course helpful when it came to determining and walking through case scenarios. It was very nice to have different case scenarios and have ‘charts’ to be able to look at and pull information from.

What did you find easiest as you went through the courses? What did you find the most difficult?

The easiest thing that I found while doing the stroke modules was how the breakdown of choosing your code was laid out. I thought this was a fabulous idea on how to work your way through the stroke tool, and it told you as you went along whether you chose the correct path or not. I not only found this helpful that it was broken down, but it made me feel comfortable with what I picked as I went along. Having the tools on the side of the screen was also very helpful when it came to picking which pathway I was going to choose for the scenario. Having it right there and not having to write everything down in my notebook was very convenient. 

The more difficult part of this, I found, was working my way through module two (intermediate). I found the basic and complex modules straightforward; however, I had some difficulty with the intermediate module. I do want to clarify that this wasn’t because of the module, but instead my lack of coding of hemorrhagic strokes. It would have been nice to have a couple more of those examples within the modules. 

Did the courses meet your expectations?

This course was very well designed and I enjoyed it a lot more than the previous stroke course that CIHI had. I found that it was an easy walkthrough and was able to learn some key points that will help with future coding of strokes. With that being said, it would’ve been interesting if you had not only added in the quiz of what codes we chose through the charts, but to add on additional questions. You could have gotten all of the in-lesson questions incorrect, but it still would have told you the correct code at the end, and then you would’ve been able to transfer those correct codes to the quiz and still get 100%. That way you are able to still answer some more quiz questions along with doing those charts within the modules. 

What are three of your key takeaways after completing the course?

  1. Having the super helpful handouts that were attached. Although we had access to the stroke tool and review process, it was also very nice to have the anatomy of the brain laid out and able to use as a quick reference tool. This was able to help with the diagnosis of codes within this course, and I’m sure within general coding.
  2. The video was a nice gesture with this course and how our data is actually getting represented within the hospitals. 
  3. Hemorrhagic strokes and the way that they are broken down within this module—to be able to learn more about them and the way that the module helps to show you why that code is chosen. 

Do you feel that the course content will be useful to apply to your work?

This course will definitely be helpful within the coding of NACRS and DAD at my place of work. Generally, I am always coding strokes at both NACRS and sometimes DAD levels, and to have this course as a reference to make sure that I am choosing the right pathway is a real help. 

Do you feel that this course bundle would be beneficial to CHIMA members?

This course would be helpful for CHIMA members who are doing coding. I’m not sure how beneficial it would be to other CHIMA members who aren’t coding and can’t speak on their behalf, as I have always coded and not done any other job within this industry.

What else would you like to see in terms of future education related to classification and coding?

Something that I think may be helpful for future education for coding would be the coding of obstetrics. I know there is a whole reading about obstetrics, but to have an interactive course on things such as the attributes and general obstetric coding would be super helpful. 


Additional course reviews were conducted by Corneliek Demeter and Claire Jamieson.

The new 5003E-Different Strokes Need Different Codes bundled course is offered at no charge to all CIHI Core Plan subscribers. You can register today by logging in to CIHI’s Client Services and selecting the Learning Centre. If you don’t have an account, you can create one here.  

Completion of this course will earn CHIMA’s professional members 3 continuing professional education (CPE) credits with the Canadian College of Health Information Management.

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