How staff can prepare for ICD-10

By now you have heard and read a lot regarding ICD-10 changes coming in October. This is the most significant coding change in health care in more than 30 years, and the impact on healthcare practices cannot be overstated. Let’s discuss some of the changes in the new diagnosis coding system and how you can prepare for the transition.

ICD-10 vs. ICD-9

The ICD-9 coding system is 30 years old and felt to be outdated. Some codes are outdated or obsolete. The additional specificity in ICD-10 provides codes for more accurate payment for new procedures, and the hope is that they will lead to fewer rejected and improper claims as well as better understanding of new procedures and improved disease management.¹ Not only are there many more codes (about 69,000 ICD-10 codes compared to about 14,000 ICD-9 codes), the format of the codes and some of the rules and conventions for assigning the codes have changed.

The biggest concern in most practices is that the conversion to ICD-10 will disrupt the claims process and, by extension, cash flow. So, it goes without saying that this change will affect the coding and billing staff.  But it goes beyond the claims process and affects more than the billers.

Medical Economics: ICD-10 documentation: The key to getting paid 

Here’s a quick look at how moving to ICD-10 will affect different roles within the office.

• Doctors. They need to better document in order to select and support the correct codes. Some doctors assume that the office’s EHR program will take care of this for them. While the EHR should be loaded with the full selection of ICD-10 codes-and it may even be able to map over from previously reported ICD-9 codes to narrow down the code choices-it should not be relied on as the final answer.

• Administrators and managers. They will oversee implementation and education and managing the report for CMS bonus programs (such as PQRS).

• Technicians and scribes. They will need to rethink how they interview patients and document in charts.

• Reception and front desk staff. They will face new forms, changes to payer policies, and requirements for precertification.

• IT staff. They must handle updates to the computer.

• Outside billing companies. They must insure that they are they compliant. 

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