Back to Basics: Send the Right Message

By Annie Boynton, BS, CPC, CPC-H, CPC-P, CPC-I, RHIT, CCS, CCS-P, CPhT


Use humor, honesty, common sense, and creativity to get your audience motivated.

As the Oct. 1, 2014 ICD-10-CM implementation deadline gets closer, time is of the essence to reassess your communications plan for the long road ahead.

At its most basic, communications involve three critical elements: a sender, a receiver, and a message. The sender and the receiver must continually interact throughout the communication for it to be successful. The sender delivers the message and the receiver provides feedback verbally or through non-verbal signs, letting the sender know if the message was understood.

Some managers and clinicians may exhibit leadership styles discouraging open communications, which severely dampen efforts to create ICD-10-CM awareness throughout an organization. Open communications—upstream and downstream—is critical to implementation success. Negative or closed-off communications harm productivity and morale.

Use Humor

I’ve had the privilege of addressing close to 15,000 people in the past 18 months concerning ICD-10-CM implementation. My most successful meetings are those where I can get the audience laughing and engaging in the subject matter. It isn’t always easy, but it seems to help secure the receipt of the ongoing message: Start doing something about ICD-10-CM before it’s too late.

When I assess ICD-10-CM communications efforts, I keep the following quotes in the back of my mind:

  • “If you’re going to tell people the truth, you’d better make them laugh. Otherwise, they’ll kill you.” –George Bernard Shaw
  • “There comes a time in the affairs of men when we must take the bull by the tail and face the situation.” –W.C. Fields

These quotes are particularly helpful in meetings where it feels I may be addressing a lynch mob rather than a group of physicians or health care administrators. Too often, audiences forget I am just the messenger, so injecting a little humor in the conversation can be a good thing for the audience (and for my health).

Be Honest, Know Your Audience

Honesty truly is the best policy in all communication efforts. When it comes to ICD-10 implementation, there isn’t a lot of good news to be had, at least not in the short term. If you don’t incorporate a little humor or some fun into your message, your audience will be unlikely to pay attention.

Connecting with your audience—whether verbally or in writing—is critical to the successful receipt of any message. Regarding ICD-10 implementation, not everyone will need the same information at the same time. For example, you wouldn’t provide a medical records clerk with the same information you would a chief financial officer (CFO)—it’s unnecessary, likely to cause confusion, and may increase the likelihood future communications will be ignored. Tailor communications to fit the audience’s needs and your communication efforts will not be in vain.

Think Outside of the Box

The mode of communication is also important. You can only receive so many emails before you start tuning them out and, ultimately, flat out ignoring them. Consider other communication modes, such as newsletters, interactive games, and demonstrations. Or, if it is in your budget, consider using videos or tchotchkes as a means of communication. You don’t have to reinvent the wheel: Consider “borrowing”’ what others have done with success.

For example, Find-a-Code created a humorous series on some ICD-10-CM external cause codes that are available on YouTube, guaranteed to get a chuckle from viewers.

AAPC created mouse pads with the ICD-10-CM code for mouse bite on them. The concept is clever, fun, and engaging.

Consider also holiday inspired ICD-10-CM greeting cards. Here is the list of codes I used in my own ICD-10-inspired Thanksgiving card to colleagues last year:

A Thanksgiving Greeting, Courtesy of ICD-10-CM

Thanksgiving can be a dangerous time of year!

T73.0           Starvation

A05.1          Botulism food poisoning

A02.0          Salmonella enteritis

E70.5           Disorders of tryptophan metabolism

R63.5           Abnormal weight gain

T18.120A    Food in esophagus causing compression of trachea, initial encounter

T18.120D     Food in esophagus causing compression of trachea, subsequent encounter

T18.120S     Food in esophagus causing compression of trachea, sequela

T18.128A    Food in esophagus causing other injury, initial encounter

T18.128D     Food in esophagus causing other injury, subsequent encounter

T18.128S     Food in esophagus causing other injury, sequela

F43.0           Acute stress reaction

Z63.79         Other stressful life events affecting family and household

What you were doing when it happened:

Y93.G3        Activity, cooking and baking

Y93.G9        Activity, other involving cooking and

Y93.G1        Activity, food preparation and clean up

Y93.61        Activity, American tackle football

Y93.62        Activity, American flag or touch football

Y93.82        Activity, spectator at an event

The method of injury:

W21.01XA   Struck by football, initial encounter

W21.01XD   Struck by football, subsequent encounter

W21.01XS   Struck by football, sequela

X15.0XXA   Contact with hot stove (kitchen), initial encounter

X15.0XXD    Contact with hot stove (kitchen), subsequent encounter

X15.0XXS    Contact with hot stove (kitchen), sequela

X10.2XXA   Contact with fats and cooking oils, initial encounter

X10.2XXD    Contact with fats and cooking oils,
subsequent encounter

X10.2XXS    Contact with fats and cooking oils, sequela

W27.4XXA  Contact with kitchen utensil, initial encounter

W27.4XXD   Contact with kitchen utensil, subsequent encounter

W27.4XXS   Contact with kitchen utensil, sequela

W26.0XXA  Contact with knife, initial encounter

W26.0XXD   Contact with knife, subsequent

W26.0XXS   Contact with knife, sequela

W29.1XXA  Contact with electric knife, initial

W29.1XXD   Contact with electric knife, subsequent encounter

W29.1XXS   Contact with electric knife, sequela

W29.0          Contact with powered kitchen appliance

The place of the incident:

Y92.010      Kitchen of single-family (private) house as the place of occurrence of the external cause

Y92.011      Dining room of single-family (private) house as the place of occurrence of the external cause

Y92.012      Bathroom of single-family (private) house as the place of occurrence of the external cause

The perpetrator of said incident:

W61.42XA   Struck by turkey, initial encounter

W61.42XD   Struck by turkey, subsequent encounter

W61.42XS   Struck by turkey, sequela

W61.43XA   Pecked by turkey, initial encounter

W61.43XD   Pecked by turkey, subsequent encounter

W61.43XS   Pecked by turkey, sequela

W61.49XA   Other contact with turkey, initial

W61.49XD   Other contact with turkey, subsequent encounter

W61.49XS   Other contact with turkey, sequela


We have one more Halloween to go before ICD-10 “goes live.” Next year, you might consider handing out black and orange candies custom-stamped with Halloween inspired codes, such as:

Ghost Vessels

H16.411       Ghost vessels (corneal), right eye

H16.412       Ghost vessels (corneal), left eye

H16.413       Ghost vessels (corneal), bilateral

H16.419       Ghost vessels (corneal), unspecified eye

Werewolf Syndrome

L68.1           Acquired hypertrichosis lanuginosa

L68.2           Localized hypertrichosis

L68.8           Other hypertrichosis

L68.9           Hypertrichosis, unspecified

Pumpkin Carving Mishaps

Y28.1XXA   Contact with knife, undetermined intent, initial encounter

Y28.1XXD   Contact with knife, undetermined intent, subsequent encounter

Y28.1XXS   Contact with knife, undetermined intent, sequela


For more holiday-inspired communications fun, Hanukkah, Christmas, and Kwanza all offer songs that can be “coded” in ICD-10. It’s a good way to get an audience thinking about the granularity of ICD-10 in a positive manner (see “End Your Chapter Year with Festive Fun” on page 12 of the December 2012 Coding Edge for more ideas).


Regardless of your budget or resources, the best advice for ICD-10 communications planning is to keep the material fresh, the message positive and interesting, and make it fun. This will ensure your audience stays engaged and receives the right message.

Annie Boynton, BS, CPC, CPC-H, CPC-P, CPC-I, RHIT, CCS, CCS-P, CPhT, is the director of 5010/ICD-10 communication, adoption, and training for UnitedHealth Group. She is an adjunct faculty member at Massachusetts Bay Community College, and a developer and member of the AAPC’s ICD-10 training team.

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