Doctor's Life Magazine, Tampa Bay Doctor's Life Tampa Bay Vol. 2 Issue 1, 2014 | Page 19
you have to make a financial investment as many people and
organizations are doing. Make sure to find the best quality
resources that are going to thoroughly prepare you and be able to
address your questions and concerns as much as possible.
There are a number of organizations that suggest up to 26
hours of education for professional coders. I believe the time will
range based on a number of things. For instance, how long has
the professional coder been coding? This is important because
sometimes it is difficult to teach mature people new behaviors.
I was a coding professional for over 15 years and I have been
working with ICD-10 for about 3-4 years and I still struggle with
being able to remove my perfected 15 year habits from ICD-9.
I will be the first to admit that the ICD-10 CM system is not
hugely different in concept but there are new rules and additional
documentation requirements for ICD-10 CM that do require you
to alter your ICD-9 thought pattern. For those coders that have the
luxury of having to learn the ICD-10 PCS system for the inpatient
setting- this is a totally different story. The ICD-10 PCS system is
entirely new and different from what coders are familiar with. This
system will require time and practice and an investment. Free tools
are great- but you have to dedicate the time and ensure that you are
getting the best resources available.
PREPARING PROVIDERS
It is necessary for physicians and other providers to understand
the importance of complete classification of diseases and
procedures in ICD-10-CM and ICD-10-PCS (depending upon their
specialty). The quality of healthcare data will help facilitate and
be responsible for setting quality of care and pay for performance
initiatives and parameters involved in disease outcome and
severity of illness as it relates to resource consumption.
Understanding the ramifications of “garbage in = garbage out”
as well as how the information is used in healthcare policy
development and profiling will help with accepting the need for
classification change.
Issue 1, 2014
Effective education for providers is critical to the success
of a smooth conversion. Some professional organizations
are suggesting anywhere from 2 to 11 hours of education for
providers. I find that this information is pretty accurate but should
be very specific to provider specialties. Keep it simple- focus on
areas per specialty. For specialties around family practice, internal
medicine, hospitalists, ER and other cross functional areas it
may require more time learning some of the new documentation
requirements in multiple areas than it does for specific areas
like orthopedics or cardiovascular. I recommend some of the
following activities to help with education efforts:
»» Education and training sessions specific to specialty and
topics requiring new documentation
»» Procedure template revision/creation to accommodate
incorporation of all key documentation elements for
specific procedures (e.g., infusions, transfusions,
injections, etc.)
»» Super bill revisions and other template updates for ICD-10
codes
IN SUMMARY
I could go on and on about ICD-10 but here is the short and
skinny- it makes sense for the most part. Professional coders and
billers need help with the appropriate documentation based on
what is known about the patient at the time of care. I will admit
there are things that I am not clear on why certain changes were
made or why some descriptions were updated, however, I do see
the value of having better quality codes. Hopefully over the next
few years after implementation, CMS will review ICD-10 codes
and make decisions for changes based on code assignments that
have been utilized and not utilized. In the meantime, don’t take
the easy way out and just assign unspecified codes. The data is
important and with the move to pay for performance and other
quality initiatives, data will be essential.
Doctor’s Life Tampa Bay
19