ICD-10 Check-Up

Posted on May 13, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

It’s hard to believe it has been seven months since we implemented ICD-10 in the US. We talked about this subject and planned for so many years and now it feels like second nature. Looking back, I would label the implementation mostly successful and smooth. Would you say the same?

If you’re like me, you have forgotten some or most ICD-9 codes and have a nice repertoire of ICD-10 diagnosis codes swimming around in your head daily. At least memorizing the beginning of a code is helpful when you only need to search the encoder for the fourth through seventh digits of the code to further specify laterality and detail.

Conducting an external audit on ICD-10 coded accounts at this point is a good idea to make sure coders are accurate with the new code set. It’s important to watch for any trends in DRG shifts that may be attributable to ICD-10. If claims data for the past seven months have not been reconciled with expected reimbursement, now is a good time to be reviewing for coding and billing accuracy.

We were promised more specificity with ICD-10 and I believe we have somewhat achieved that. There are still opportunities to improve physician documentation and gather more detail in order to assign the correct codes. For the most part, I believe physicians have been affected by HIM teams bringing awareness to specific documentation and education on what is needed for ICD-10 coding and billing. ICD-10 has not turned out to be the burden that everyone was initially so reluctant to; at least from my experience.

In the blog post I wrote soon after ICD-10 implementation, I mentioned that coder productivity was a big issue to watch for with ICD-10. With sophisticated coding tools, thorough training, and skilled coders, the productivity impact has been real but not nearly to the extent some HIM managers were bracing for. We are starting to see coder productivity come to a manageable level that will probably be the norm for the foreseeable future.

I’m happy to report that I feel confident in ICD-10 as our designated code set and based on peer input, I think others will agree. The specificity was much needed after many years of vague or catch-all codes. This paves the way for better data reporting and thus more quality information resulting in better disease management. Accurate reimbursement is an obvious bonus as well.

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