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Nursing Informatics & Technology: A Blog for All Levels of Users

Nursing's Role in ICD-10 & Meaningful Use

Published April 25, 2011 7:34 AM by Denise Tyler

On Oct. 1, 2013, in between the meaningful use stages 2 and 3, compliance is mandated for the implementation of the International Classification of Diseases, 10th revision, or ICD-10.  

ICD-10 has been used by most other countries since 1989.

The impact is NOT limited to medical records coding or physicians' documentation and billing. Yes, the impact on coding for medical records staff is significant (going from 13,000 codes to 120,000), but the revenue cycle will be affected, and the documentation required of physicians will be impacted - and the impact does not stop there. 

Clinical charging and clinical documentation will also be affected.  While most people think of ICD as a coding system for billing, Dan Rode says, "ICD-10 will allow more automated, computer-assisted coding - and coders will turn into editors." 

How will nurses be impacted?  Any charting that is used by coders for billing will need to include clearer details. ICD-10 requires more details in clinical documentation for problems, assessments, procedures and treatments.  Mark Sugrue, RN-BC, gives the example of pressure ulcers. With ICD-9, there were nine codes, with ICD-10 there are over 125 codes. 

Nurses will be collaborating on meeting the requirements for both ICD-10 and Meaningful Use.  Nurses who specialize in informatics will be working with interdisciplinary teams to modify clinical documentation and workflow to achieve the rigor necessary to meet these challenges and more. 

How has your place of work been affected by the meaningful use requirements and ICD-10?  Who is working to meet these needs, and how can you help?

This blog is brought to you by ADVANCE and Intel.
posted by Denise Tyler


General question:

Can non-credentialed staff enter charting data into an EHR for nursing staff?  Assumption is that Nursing staff will not authenticated or quality check the data.

Jeff Pierson, Public Health - Administrator May 8, 2015 2:34 PM

Just inquiring  ,planned to retire soon ,need partime work at home

Lorna, Psychiatry - RN, Sch January 20, 2015 5:41 PM
Culver city CA

The field of Clinical Documentation Improvement is presenting new opportunities for nursing.  With the advent of ICD-10, nurses with have the opportunity to greatly impact the quality and accuracy of documentation.

Kristine Meyer, Clinical Documentation Improvement - RN, MSN, Clinical Documentation Specialist, Optum 360 January 14, 2015 10:30 AM
Phoenix AZ

I am very interested in Education and thus learning and being part of the new frontier of coding ICD 10.

Janet Strayhorn, Infection Control - RN MSN Ed January 1, 2015 7:51 PM
Ada OK

The opportunities for nurses who know coding in general and ICD10 specifically are already manifesting!  The RN-Coder Network is being contacted by potential employers each week.  We offer the CE training programs for nurses, physicians, paramedics, pharmacists who want to learn ICD10 coding.  Go to for details.  For positions in your area, go to and use the following key words:  "RN-Coder, nurse coder, RN-Auditor, nurse auditor, CDI, Remote coding, ICD10" with your area and email.  You'll start receiving job postings.  But you will need to be certified as a clinical coder.  Go to for details.

JOYCE Thomas February 18, 2014 7:15 PM
Diamond Bar CA

I am extremely interested in this transition- Currently in the ER (RN) trying to break thru to a entry level with my MS in informatics to gain the 'required experience' to take the certification exams to get the experience& employment!  Despite excellent performance evaluations from employers  and tenacious decades of competency, I cannot seem to break the catch 22- need both experience and certifications to get started with coding!  I'd like to professionally grow to learn auditing !! What are my options?

Thank you, Rose

Rose, ER - RN, hospital February 9, 2014 12:25 PM

I want to learn how to become a nurse encoder and how is the

Job market?

Marissa Hoy, ED/ ICU/GI lab - RN January 26, 2014 7:06 PM
Glendora CA

RNs will play a significant role in the transition from ICD9 to ICD10.  RNs, who have been trained in both ICD9 and ICD10 have assisted the CDC for the past several years in transitioning our ICD9 data into ICD10 for report to the world health community.  Certified RN-Coders and Certified RN-Auditors will take the lead in this momentous transition -- and indeed will actually make it happen!  RNs walk in with experience understanding anatomy & physiology, disease process, can read a complicated surgical report, can understand when the physician explains what happened and how it was treated, etc.  RN-Coders will be the team leaders, heading up the transition team, translating between the physicians and HIM, assuring documentation is adequate, and training anyone and everyone who needs to learn ICD10CM and/or ICD10PCS.  The RN-Coder Network, Inc. has a specific training program just for RNs to learn ICD10!

Joyce Thomas, healthcare coding - President, RN-Coder Network, Inc. June 24, 2011 3:05 PM
Diamond Bar CA

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    Occupation: Nursing informatics experts and enthusiasts
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