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CDI: Just Tell Me What to Say

Preparing Physicians for ICD-10: Easier Than You Think

Published February 7, 2013 1:55 PM by Alice Zentner

HIM's longstanding struggle with physician documentation is well understood and globally recognized. The challenges associated with securing complete, timely, and accurate documentation from physicians is fodder for HIM jokes nationwide. Yes, nine out of  10 coders around the water cooler agree ... physicians are a tough bunch.

So with ICD-10 only one year away, how can you change up the CDI game plan to better educate your physicians, obtain stronger cooperation, and ensure coders have the documentation they need? Here are six practical ways to address the challenge:

1. Focus Your Efforts

When talking to physicians about ICD-10, focus your presentations and communications on those diagnosis and procedures specific to them. Address each department/service separately, and use real, practical examples for each, comparing differences in verbiage between ICD-10 and ICD-9. The type of practice or specialty is a big factor in the intensity and duration of education. Plan accordingly.

2. Reiterate the Benefits of ICD-10 to Their Practices

Physicians are most concerned about the impact of ICD-10 on their practices and personal revenue. So tell them.

The physician side of healthcare coding and billing is retaining CPT codes, so only diagnosis coding will change in the office setting. And while physician payment is not driven by diagnosis, medical necessity for each CPT code is.

Having correct documentation and diagnosis coding to prove medical necessity under ICD-10 will be a hot issue for physicians, especially if denials spike and reimbursements are halted. Furthermore, RACs are expanding into physician practice settings. Better documentation reduces denials, audits, and take-backs. Finally, a physician's quality scores and HealthGrades are directly impacted by correct documentation and coding.

Three specific areas that affect documentation in the physician office setting are: pathologic fractures, stages of chronic kidney disease, and trimester of pregnancy. Stay tuned to this blog as we uncover more areas within physician practice settings where adherence to new, ICD-10 driven documentation will be required.

3. Educate in Small Bites

Just like the title of this blog states, physicians want HIM to "tell them what to say." Consider short briefings, factoids, info graphics, and documentation tips that are easily digestible and transportable. Attention spans are short. Keep your message simple.

4. Go Mobile

Consider applications that push ICD-10 education and documentation reminders to physicians via mobile devices and texting. Make education fun and interactive whenever possible to keep your audience engaged. For example, many of ICD-10's funny codes can be used to both entertain and demonstrate new specificity requirements.

5. Use a Peer-to-Peer Approach

No one communicates your message better than another physician. Every effort should be made to engage multiple physician champions for peer-to-peer conversations and education. No physicians around? Consider PAs and other respected clinicians to serve in these roles. And always ask your medical staff leadership to help.

6. Inspire Competition

Whether it is on the golf course or in the parking lot, physicians are a competitive bunch. Take advantage of this trait, and set up I-10 documentation challenges. Post results, and award prizes in the physician lounge. A little competition goes a long way. 

The move to ICD-10 is a project where it is virtually impossible to cover everything and do a broad brush implementation. The shotgun approach will result in time wasted and disinterest in success. Use a tailored, custom approach for physicians - molding the implementation to the specific needs of physicians and their practices. Being specialty-focused takes more time but pays off in big dividends.


Do any of your webinars offer AHIMA CEUs?

Ellen February 12, 2013 8:51 AM

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