Time has not been wasted.

By: pmginc

Categories: PMG Insights Blog

June 3, 2014

So everyone is really, and I mean really tired of hearing about ICD 10, and the latest onslaught of daily emails all addressing new programs and steps to take to train and be ready.  Some of you are thinking that “I spent all that time training staff, and now they won’t use those new skills for a full year!  Will I need refresher courses?”

I would challenge you to look at this in a different view.  Obviously if you were proactive enough to start the ICD 10 training early you had something in mind when doing so.  Let’s look at how you can put those newly trained coders and billers to work and keep the value in your investment.

If you had worked through your “discovery process” and gap analysis you know that there were several areas that were going to need special attention in order to maintain some data integrity.  Here are three areas where your ICD 10 trained staff can help.

First:  Look at your patient problem lists.  Right now the patient record within the EMR keeps a description of the patient diagnoses.  And with those descriptions is an ICD-9-CM code. And in October 2015, those codes will need to be ICD-10 codes. 

We have heard from some team leads that tell us that one or two systems will make a conversion from ICD-9 to ICD-10 codes.  But, the majority will not.  And that means somehow, within your organization, someone needs to do that crosswalk. 

Who better, than the newly trained coder or biller, to handle that task?  Now granted it’s a big job.  But if the coder or biller does several of these everyday (all patients scheduled each day), the coder is going to keep their skills current, the problem list will be updated, and the providers will have current ICD-10 codes from which to work when the patient is seen in October 2015. 

I would be a bit leery of those systems that will do the crosswalks for you.  The information that is returned can only be as good as the original ICD 9 codes.  That means all those unspecified codes used with ICD-9 translate to unspecified codes in ICD 10.  You will want to check out those crosswalks and see how you can create better data with a hands-on review by staff.  Getting rid of unspecified codes is the best thing you can do for improving your coding and subsequently reimbursement in 2015.  

Second:  There is no doubt that organizations have spent a lot of time and money to get systems up to date by the original deadline (Oct 2014—yeah I know, the original original deadline was much earlier than that!).  But with each upgrade comes the requirement to test the system to make sure all is good and that the system will accommodate the ICD 10 codes.  In order to test your system, it really helps to know how the data will look and report.  If you are using “dummy codes” instead of the real thing, have you really been able to test drive your system to its potential?  So if you have trained staff now, it makes good sense to employ them in the testing of your system, and realize that potential or find errors that will cause problems down the road.

Third:  Providers who have started with their training have the advantage of understanding not only the coding requirements but the documentation requirements as well.  For every description of a diagnosis the documentation must illustrate what leads to that diagnosis.   For example, documenting moderately persistent asthma and the related symptoms that make the call for moderately persistent asthma, instead of just asthma is the key to using an appropriate ICD-10 code. 

But providers don’t need to wait until October 2015 to start improving their documentation.  If providers start now, then a chart review done later in 2014 should show the improvement.  You can establish your provider education program with an understanding of current documentation patterns and habits, and tailor that program to each provider.  End result will be better educated providers, well documented records, and the basis established for better reimbursement in the future.

So—no need to wait to get the training done.  If you did it already, three cheers.  If you thought about waiting until next year, perhaps it’s time to reevaluate that decision.  There is still much to be done for the ICD-10 implementation.  The breathing time has ended and it is time to get back into the project.  October 1, 2015 will be here before we know it.