Is Your Practice Ready For ICD-10 Implementation


Are you ready for ICD-10? Well whether you are or not it’s coming and its not being delayed any longer. Come to find out, the rest of the world has been using ICD-10 codes for the past two decades, and not only that but the United States endorsed ICD-10 in 1995 and began using it for monthly reporting in 1999. But, wait you say, yes you have it straight, ICD-10 has been around for a long time but we have just been behind the power curve. Now under the new health care reform it is mandatory for medical providers to utilize ICD-10 and they must be in compliance by October 1, 2014. 

Providers will be still treating the same patients and conditions just using different codes. The reason for the switch from ICD-9 to ICD-10 is that ICD-10 captures more information relevant to the condition and diagnosis so that the treatment is more specific. Here is a table so you can see a side by side comparison of ICD-9 and ICD-10 and the differences between them. 

ICD-9-CM Diagnosis Codes                        vs.                    ICD-10-CM Diagnosis Codes
3 to 5 Digits
7 digits
Alpha E and V on 1st character
Alpha or numeric for any character
No place holder characters
Include place holder characters
Terminology
Similar
Index & Tabular Structure
Similar
Coding Guidelines
Somewhat similar
Approximately 14,000 codes
Approximately 69,000 codes
Severity parameters limited
Extensive severity parameters
Does not include laterally
Common definition of laterally
Combination codes limited
Combination codes common
As you can see from the table above their are some differences and similarities between ICD-9 and ICD-10.

Now let’s talk about the advantages of ICD-10. The Centers for Medicare & Medicaid Services has given us nine and here they are:

  •  Measuring the quality, safety and efficacy of care
  •  Designing payment systems and processing claims for reimbursement
  •  Conducting research, epidemiological studies, and clinical trials
  •  Setting health policy
  •  Operational and strategic planning and designing health care delivery systems
  •  Monitoring resource utilization
  •  Improving clinical, financial, and administrative performance
  •  Preventing and detecting health care fraud and abuse
  •  Tracking public concerns and assessing risks of adverse public health events

That’s just nine. There are plenty more and more shall be reveled once the new code set takes its course and the medical providers are receiving the payments they deserve. 
Lets talk about the implementation process of ICD-I0 and the three main professional roles:
The role of the clinician is to document as accurately as possible the nature of the patient conditions and services done to maintain or improve those conditions.
The role of the coding professional is to assure that coding is consistent with the documentation.
The role of the business manager is to assure that all billing is accurately coded and supported by the documented facts. 
When each of these professionals to do their job correctly the practice is able to stand-up to an audit because the documentation  supports the coding.
So I ask again is your provider, coder, and manager ready for ICD-10 implementation?
My suggestions are to come up with an implementation plan that outlines the duties of everyone involved, define the purpose, plan appropriately, create deadlines, assess your risk, and most importantly make sure your EMR system and practice management system can withstand after this implementation.
Is your EMR and practice management system ready for ICD-10? If, so how much will it cost?
EMRx and iClaim is ready for ICD-10 and there is no upgrade fees!!
Let the Evolving Efficient Experts in Healthcare give you a real time solution for the real time problem you are facing. Contact us today so you can see how our solutions are bridging the gap in the healthcare industry.
Phone: (888) 338-7293  Fax: (888) 391-2109
References:
DEPARTMENT OF HEALTH AND HUMAN SERVICES , Centers for Medicare & Medicaid Services. (2011). Icd-10-cm classification enhancements. Retrieved from website: http://www.cms.gov/Medicare/Coding/ICD10/downloads/ICD-10QuickRefer.pdf
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