Preparing for ICD-10

February 25th, 2013 - Codapedia Editor
Categories:   Diagnosis Coding   Diagnostic Testing  
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The CEO of a third party administrator said to me recently, “ICD-10 is giving even me a headache.”  Two years before implementation and he’s getting a headache.  Well, he has bits and bytes to worry about.  On the physician side, all we have to worry about is selecting the correct code, and having a practice management system that can accept it and transmit it.  By now, everyone has heard dire predictions about the impossible complexity of ICD-10.  Commercial vendors and consultants are anticipating a full schedule of clients for 2013.  But, before we all panic, let’s a breath.

First, it is going to be much harder for facilities than for physicians.  It’s true that the number of possible diagnosis codes will increase from 14,315 to 69,101.  But, each of those codes is listed in the ICD-10 book.  The book has a familiar format, and many of the rules are the same as for ICD-9.  

Here are a few easy steps to an almost painless ICD-10 transition for your practice.

Buy an ICD-10 book: Spent the money on the draft version of ICD-10 right now. 

Try to code the most common conditions in your practice:  This will be easier for single specialty practices than for multi-specialty groups, or for primary care and General Surgery, which tend to treat patients with many conditions.  Print a list of the twenty most common diagnosis codes submitted on claims.  Try to code them.  You’ll find one of these results:

·      You can code the conditions and find the correct ICD-10 code.  Hurray!  Try the next twenty diagnosis codes next month.

·      You are unable to select the correct code because you lack the clinical knowledge to do so.  Unfortunately, it is true that ICD-10 requires coders to know more about clinical conditions.  If you find this, sign up for an Anatomy and Physiology course, on line or in person.  Take an ICD-9 coding course.  You may ask how that will help when ICD-9 is going away.  If you are proficient at ICD-9 coding you will find the transition to ICD-10 much easier.

·      You have the coding ability and clinical knowledge to select the correct diagnosis code, but neither the encounter form nor the medical record provide enough specificity.  (Which artery?  Was the fracture at the distal or proximal end of the bone?  Right foot?  Stable?)  Start now giving clinicians feedback about the level of specificity that is required for their own specialty.  Use a “tip of the week” format to post or text a single suggestion a week.

Your practice management software will need to be upgraded to the most recent version.  This may be a significant cost for some groups, who are one, two or more versions behind the current release.  Practice management vendors are going to be swamped in 2013.  Don’t wait until the last minute.

There’s no need to plan your retirement party for September of 2013.  You can learn ICD-10, and as a bonus, learning those skills will improve your career.



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