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HIM & Heard

ICD-9 sky is NOT falling?

Published February 8, 2012 10:38 AM by Stephanie Cecchini

Physicians have been told the ICD-9 sky is falling and their practice will grind to a halt if they don't properly prepare for ICD-10.  For over a decade the physician's practice has been fighting tangible tigers ---stiff regulatory compliance, decreased fee schedules, and increasing expenses. The result is that it became easy to tune out the ICD-10 chatter. The reality of an October 1, 2013 deadline means the time for action has arrived.  Although the impact of ICD-10 on physicians remains ambiguous for many, the bottom line is clear: there is a danger of revenue cycle performance issues, decreased productivity, and time lost from patient care.  What does the physician practice need to do to minimize the effect of uncertainty on objectives?

Educated staff and tailored documentation training for physicians are the most important steps a practice can take now to reduce revenue cycle and productivity risks.  While most physicians don't need to be as fluent in ICD-10 as a coder, they need to provide enough detail in their documentation for the coder to select a code with finer granularity.  This means efficiently tailoring the training to match the physician's unique style of practice.  The physician's medical specialty plays a big part in narrowing the learning curve.  For example, an orthopedic surgeon won't usually need to learn documentation requirements for trimester notations in OB care; nor do many cardiologists have interest in learning the requirements for documenting open fractures according to Gustilo classification.   Practices should begin with a review of their superbill to make a comparative study using CMS General Equivalence Mappings (GEMS) to crosswalk the old and new codes.  GEMS aren't a substitute for learning how to use the ICD-10-CM, which will take most coders an average of 15 to 25 hours.  It will help identify where to focus training for maximum efficiency.  Trained staff becomes the fastest and easiest resource for the physician.

Clinical Document Improvement (CDI) programs help to identify gaps and opportunities.  Practices that haven't yet started will lose an important advantage.  Preparing now spreads the necessary work and training across nearly two years, rather than facing it all at one time and sacrificing focus from patient care.  The ICD-9 sky is not falling yet, but waiting much longer to start CDI is risky.  The time to start is now.

posted by Stephanie Cecchini
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