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CDI: Just Tell Me What to Say

The Times ... They are a Changing

Published September 20, 2011 12:25 PM by Alice Zentner
With all due apologies to Bob Dylan, there are many ‘times a changing' in ICD-10 that require clinical documentation improvement (CDI) intervention. Our big day starts in 24 months, but coder and physician education regarding some of these time-sensitive definitions must begin now. In this blog, I present just a few "changing times" for your consideration and group discussions.
  • Asthma

In the pulmonary section under asthma, ICD-10 uses the phrases "intermittent" and "persistent." These new phrases will be defined by frequency and intensity in order to differentiate the two. Organizations should begin now to establish specific definitions and educate physicians.

  • Myocardial Infarction

In ICD-9 the time requirement to code a "subsequent MI" is 6 weeks. However, in ICD-10, the same time frame is shortened to only 4 weeks.

  • Peri-Natal and Post-Partum

The diagnosis times for post-partum issues and peri-natal issues are also changing in ICD-10. These can be found in the obstetrics section.

  • Operative Complications

In MCD11, the urinary system, ICD-9 combines intra-op and post-op complications. These are separated in ICD-10.This will force closer scrutiny of the op notes and post-op notes to determine the time of the complication.

Clinical documentation under ICD-10 requires much more detail and specificity. Coders and physician, who have been at it for years, will have to learn all about the new "times" and incorporate them into their every day vernacular. So, in may ways, the times they are a changin'!

posted by Alice Zentner
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