Skip to main content

Keep Calm and ICD-10 On

From the AAPC regarding the ICD-10 Delay:

May 8th, 2014
Keep Calm and ICD-10 On
“The Secretary of Health and Human Services may  not, prior to October 1, 2015, adopt ICD-10 code sets as the standard for code sets under section 1173(c) of the Social Security Act (42 U.S.C. 1320d-2(c)) and section 162.1002 of title 45, code of Federal Regulations.” That was the sentence in the Protecting Access to Medicare Act that has caused such a ruckus. Now what?
Coders: If you do not have a clinical background, take an Anatomy and Pathophysiology course. It will assist with understanding the signs/symptoms/manifestations of multiple conditions. This may allow for proper code assignment without as many queries to the providers. Obtaining education on the code set can allow for understanding of how ICD-9-CM differs from ICD-10-CM. This can allow for assessing how much training may be necessary for the practice or facility to get them ready for ICD-10. Coders that have received ICD-10 training can perform readiness assessments on their providers to help them with documentation improvement. They can assist with end-to-end testing with health plans that are moving forward with their ICD-10 preparation. They practice dual coding to keep their skills up.  AAPC will offer free refresher webinars to those who have taken their ICD-10 code set training with us prior to October 1 of this year to help keep things fresh.
Physicians/Other Providers: Since ICD-10-CM has a higher level of granularity and coding is based on documentation, working with the physicians and other providers on documentation improvement is one of the best things a practice can do. Assessing the documentation today against ICD-10-CM standards will highlight the areas that need to be worked on to meet them. If you have multiple providers or multiple facilities, this will take time. You cannot expect someone to change their documentation habits of years in a matter of weeks. Just imagine the time to run the reports, pull and copy the records, perform the assessment, put together the reports, and meet with each provider individually. Now imagine that with 5 physicians/providers, 10, 20. Then imagine how many times that will take to work through the top 10 or 20 diagnoses of their patient base. Physicians and providers that perform their own coding will also need code set training on top of this.
Management: There are many things that management will also need to do. The timelines for all ICD-10 implementation steps will need to be reassessed, including, the educational plan and health plan contract reviews and negotiations. The budget will have to be adjusted to meet the new deadline. More in-depth testing of ICD-10 data and generating financial models showing the impact on claims reimbursement can be performed, but only if ICD-10 codes are understood by the practice.
Use your time wisely. Keep moving forward. Keep calm and ICD-10 on.



http://news.aapc.com/?p=27322?utm_source=Code+Set+Training&utm_medium=Email-5-9-14&utm_campaign=ICDTR-5-9-14


Labels:
Location: Poway, CA, USA

Comments

Post a Comment

Popular posts from this blog

Guidelines for HIV coding

Chapter 1: Certain Infectious and Parasitic diseases (A00-B99) Human Immunodeficiency virus (HIV) Infections B20 Human immunodeficiency virus (HIV) disease (symptomatic) R75 Inconclusive laboratory evidence of human immunodeficiency virus (HIV) Z20.6 Contact with and exposure to human immunodeficiency virus (HIV) Z11.4 Encounter for screening for human immunodeficiency virus (HIV) Z71.7 human immunodeficiency virus [HIV] counseling Z21 Asymptomatic human immunodeficiency virus (HIV) infection status “Confirmation” does NOT require documentation for positive serology or culture for HIV; the provider’s diagnostic statement that the patient is HIV positive, or has an HIV-related illness is sufficient.   Once a patient is diagnosed with B20, they should never be assigned R75 or Z21. Sequencing of HIV Codes B20 should be sequenced as the first-listed diagnosis when patient is treated for an HIV related condition. Any non-related conditions get sequenced followi...
14 comments
Read more

Table VI-4. Disease Hierarchies for the 2017 CMS-HCC Model

If the Disease Group is Listed in this column… …Then drop the Disease Group(s) listed in this column is found here : Announcement of Calendar Year (CY) 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter Found at: https://www.cms.gov/Medicare/HealthPlans/MedicareAdvtgSpecRateStats/Downloads/Announcement2017.pdf P 87 If the Disease Group is Listed in this column… …Then drop the Disease Group(s) listed in this column Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.  The information presented herein is for general informational purposes only and is accurate as of the dat...
1 comment
Read more

Major Depressive Disorder

Major depressive disorder According to the American Psychiatric Association, major depressive disorder can be seen in patients who have suffered a depressive episode lasting at least two weeks, as manifested by at least five of the following symptoms: depressed mood, loss of interest or pleasure in most or all activities, insomnia or hypersomnia, change in appetite or weight, psychomotor retardation or agitation, low energy, poor concentration, thoughts of worthlessness or guilt, and recurrent thoughts about death or suicidal ideation. Major depression is highly recurrent, with recurrent episodes occurring in 50% or more of patients. Remission and recovery from major depression Whether or not a patient is being treated for depression (e.g., counseling and/or medication), remission can be defined as a level of depressive symptoms basically indistinguishable from that in someone who has never been depressed. When reporting history of major depressive disorder, instead of coding V1...
9 comments
Read more