FEATURED ARTICLE: What Now? FAQs
With the recent CMS delay of ICD-10 multiple questions have been asked. Many have expressed concerns about continuing with their current implementation plans while some organizations have made the decision to hold any further efforts towards implementing ICD-10. Here are answers to some of the most frequently asked questions –
Question: Why should we keep working at ICD-10 when we now have at least one more year until implementation?
Answer: Moving ahead allows time for fine tuning your training. It will allow time for Coders to use the code set either by utilizing dual coding or by performing documentation assessments. Using the codes will enhance your proficiency. Now is a good time to contact your vendors to see what progress they are making including the payer organizations.
Question: My physicians do not want to hear about ICD-10 and are resistant to providing education. How do I engage them?
Answer: One of the biggest challenges when implementing ICD-10 is the lack of appropriate documentation. Improving clinical documentation should be addressed as quality improvement. In addition, complete documentation is a means of supporting medical necessity for services such as Evaluation and Management, diagnostic testing, and surgical procedures. Good clinical documentation is essential, whether one is coding in ICD-9 or ICD-10.
Question: When looking at our current documentation for ICD-10 readiness, what should we be looking for?
Answer: The first step should be reviewing the physician’s most commonly utilized ICD-9 codes. Pull documentation for those ICD-9 codes and determine if a code can be assigned using ICD-10, without the use of unspecified codes.
Question: Is it true that payers will not reimburse for unspecified codes?
Answer: The jury is still out on that – however in some situations where a patient is still undergoing diagnostic testing, an unspecified code may be the only option available. But common sense tell us that if the code is specific to a time parameter, such as acute or chronic; or laterality with left or right, this information should be included in the documentation. To determine what specific area to address in clinical documentation improvement, start with the area that is most common and will require the least effort. When that concept is mastered then move to the next or more complex concept. If the concept can be templated within the EMR, or even on the paper template, it will serve as a reminder to the physician to document the concept each time.