Use of the ICD-10 coding standard will no longer be optional after October 1. After that time, medical claims submitted without the correct ICD-10 codes will be rejected. Learning ICD-10 is comparable to learning a new language, one that is much more complex than ICD-9.
The International Statistical Classification of Diseases and Related Health Problems (ICD), was developed as a consistent framework for documenting diseases, symptoms, and medical procedures. ICD-9 has been in use since 1979, and technology and medical research have made huge advancements during that time period. Whereas ICD-9 had around 17,000 different codes, ICD-10 has more than 150,000. ICD-9 simply isn't sufficient for today's healthcare environment.
Differences Between ICD-9 and ICD-10
There are actually two parts to ICD-10:
• ICD-10-CM - for clinical modification replaces the first two volumes of ICD-9
• ICD-10-PCS - created by the Centers for Medicare and Medicaid Studies (CMS), and which replaces Volume 3 of ICD-9.
The ICD-10 codes will contain much more information, with a single code representing a disease and how it is manifested. ICD-10 codes also include information about laterality (which side of the body is affected, such as with a broken arm). While implementing 150,000 new codes may appear daunting, ultimately adoption of ICD-10 will streamline the insurance claim submission process, because fewer supporting documents and requests for additional information will be required.
Rote Memorization Isn't Going to Work With ICD-10
Think about visiting a foreign country. If you're only going to be there a few days, then memorizing some key phrases may be adequate for your communication needs. If you choose to move there, however, memorization won't get you far. Instead you have to learn the language from the ground up. Soon everyone will be "speaking" ICD-10, and a fundamental understanding of this medical language is essential to your facility's success.
Medical coding and billing staff will need training and practice using the software that takes in data and interprets codes. In healthcare facilities with electronic medical records (EMRs), coding and billing professionals will have to learn how ICD-10 codes are used with the EMR software.
Training Can Make a Significant Difference in the Success of Your ICD-10 Conversion
Training and hands-on experience are the keys to making a successful conversion from ICD-9 to ICD-10. Both the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA) offer training courses in ICD-10, and the CMS has a collection of online resources to help different types of facilities make the transition with minimal disruption. Maintaining coding certification through continuing education is required for certified coders in any case, and coders who learned on ICD-9 should be given every opportunity to train on ICD-10, even if it means hiring temporary coding professionals to step in and relieve some of the day-to-day workload during training.
Why The Right EMR Makes a Positive Difference
Well-designed EMRs have the potential for making the changeover to ICD-10 easier and less disruptive. However, an EMR system that is of low quality may actually add to problems during the transition period. Some medical practices think that since their EMR vendor told them that ICD-10 would be "taken care of," they don't need to worry about training staff members. But nothing could be further from the truth.
If your EMR solution offers the following features, then it may help, rather than hinder, your facility's conversion to ICD-10:
- Access to previous patient visits
- Integrates ICD-10 search capabilities
- Templates that can be customized to prompt users for specific details
- The ability to integrate patient radiology, lab, and pharmacy data into records
While a great EMR solution may facilitate a smooth transition to ICD-10, the EMR alone can't take care of the whole process. There's no substitute for training and practice for your coding and billing professionals, and while this may mean extra expenses up front, it should provide a positive return on investment by minimizing the upheaval caused by the transition.
GroupOne Health Source is a national leader in full-service EMR medical billing, sales and implementation of EMR solutions, and consulting on all phases of the healthcare revenue cycle. We understand how big the switch to ICD-10 is, and are ready to help practices of all sizes and types plan for and execute a successful conversion. If you would like to learn more about how GroupOne Health Source can assist with your ICD-10 deployment, please contact us at firstname.lastname@example.org or at 800.769.5288.