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Issue #21 - March 14, 2012
AAPC ICD-10 Newsletter


Featured Article
In the News
Coding Snapshot
ICD-10 Strategies
ICD-10 Resource


Anatomy & Pathophysiology Online

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Office Workflow in an ICD-10 World

How does your office run today? The effects of ICD-10 will be felt throughout the office. Let's consider a few areas.

Front Desk: The status of participation in certain plans may change. The front desk staff will need to be able to explain this to patients when they make appointments on the phone or when they present for visits. There may be new privacy policies that need to be explained and agreed to by patients.

Nurses Station: The nursing staff may have to learn new pre-authorization formats and procedures. They may be called upon to assist the providers with questions on ICD-10 and may need to revise how they perform intake operations for patients. More Advanced Beneficiary Notices (ABNs) may need to be signed by the patient under the more specific code set.

Coding/Billing: The coding staff will need to evaluate a larger code set to assign a code, or assess the code assigned by the provider. They will be called upon for education of the new code set. Billers will need to understand the new payer policies that may become effective under ICD-10. Appeals processes may be different.

Providers: Providers will need to understand any changes to their specialty resulting from the new code set. They may need to adjust documentation to meet the new changes.

The effect of ICD-10 will be felt throughout the office. Take the time now to determine how extensive the changes will be and where they will be felt the most. This will help you figure out your game plan on how to adapt to the new code set in your practice.


Live From AAPCTalk-Ten-Tuesday Broadcasts Live from AAPC Conference
Talk-Ten-Tuesday, the popular live podcast produced by, will take its show on the road and broadcast live from the exhibit hall of AAPC's National Conference in Las Vegas (April 1 - 4, 2012). The live broadcasts begin Monday, April 2, when the long-running Monitor Monday goes on the air at its usual time. There will also be live shows from the remote studio booth as program hosts Chuck Buck and Kim Charland welcome such national leaders as Reed Pew, AAPC chairman and CEO; Rhonda Buckholtz, AAPC vice president of ICD-10 training and education; Annie Boynton, director of 5010/ICD-10 communication, adoption, and training for UnitedHealth Group; Joe Nichols, MD, board certified orthopaedic surgeon with a long history in health information technology; Kimberly Reid, director of ICD-10 development and training for AAPC; and many more, during live broadcasts Monday through Wednesday. Register to listen.


A patient presents today to discuss the results of her skin biopsy.

Alice came in today for a follow-up visit. We performed a biopsy on her left ear last week. She had reported that she noticed a small lesion a few months ago. It recently began to grow so she came in to get it checked. She has spent years in the sun and until recently did not wear any sun protection.

A recheck of the site was performed and the lesion looked to be of the same size as when examined in the office last week. It is not painful to the touch.

ASSESSMENT/PLAN: Basal cell carcinoma left ear – confirmed by pathology. We have discussed the treatment options and Alice wishes to have surgical excision performed. We will send her to the dermatologist to have this performed as soon as possible. We will see her back as necessary.

ICD-10-CM Codes:
C44.219 Basal cell carcinoma of skin of left ear and external auricular canal

Rationale: In ICD-10-CM, the codes for neoplasm of the skin are broken down by site, laterality, and type. There are separate codes for melanoma, Merkel cell carcinoma, basal cell carcinoma, squamous cell carcinoma, other, and unspecified.

ICD-10 Implementation Strategies

In this section, we share strategies to help your practice successfully implement ICD-10-CM. Please remember to track your progress in your ICD-10 Implementation Tracker on AAPC's website.

Educational Plan
Everyone in your office, clinic, or facility will need some form of ICD-10-CM education. An educational plan will allow for a timeline that ensures everyone gets what they need at the right time. Obviously, everyone can't receive education at the same time. Depending on the size of your practice, a planned and coordinated effort may be required to guarantee training for everyone (front office staff, nursing staff, coding/billing staff, providers, management, etc.). The first step is to separate staff into training groups (like those listed above) and decide how much training each group needs. Then, look at your resources and options and decide on how to deliver the training (onsite consulting, live training outside the office, train-the-trainer internal, or a combination of methods). Finally, set a schedule for who will get trained and at what time.


ICD-10 Provider Office Changes Floor Plan
There's more to ICD-10 than just learning a new code set and upgrading your software. The transition will affect every aspect of your practice. This floor plan outlines some of those changes.

ICD-10 Provider Officer Changes Floor Plan

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