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Preparation for ICD-10 Implementation

Coding Corner

The information provided here applies to Medicare coding. Be sure to check with your Medicare Administrative Contractor (MAC) for additional information and clarification on these and other items. You should also contact your local insurance carriers to determine if private insurers follow Medicare's lead on all coding matters.

Preparation for ICD-10 Implementation Begins With Understanding ICD-9

The much-anticipated 2015 implementation of ICD-10 is less than five months away. Last year at about this time, training was gearing up, classes were full and my August and September schedule was packed. Then Congress passed a bill that included a small, simple sentence that delayed ICD-10 another year and cost the healthcare industry upwards of $6.5 billion.  As I look at my schedule this year for ICD-10 trainings, it is a bleak one. Offices tell me that they are waiting “to be sure.”  Yes, there is a very small chance that legislation may be passed to further delay ICD-10 implementation, but what if it is not?  Your office will be in a difficult position to say the least.

A simple suggestion is to take the next two to three months and become better acquainted with ICD-9.  It will not be lost learning.  Many physicians lack sufficient knowledge of ICD-9 coding. It is by no fault of their own. Physicians were thrust into the role of “coder” with the adoption of electronic health record systems. You may have received some training on how to find a code with the software, but probably not on how a code is to be used properly in conjunction with other codes, how to use proper specificity and proper ordering of multiple codes in the medical record.  Most of the physicians I have worked with have experienced no formal training in coding.  Given the choice, I would encourage coders to work in conjunction with physicians as stated in the Coding Guidelines of ICD-9 and ICD-10. These guidelines state that proper code selection is a joint effort between both the coder and the physician.

If you are like many physicians and find yourself struggling to assign an ICD-9 number to your patient’s illness, a bit of training can only help.  Then, if ICD-10 implementation is not rescinded, that training will serve you well as a foundation for ICD-10.  The two code sets are amazingly similar and their guidelines are only five percent different. Take a class in the next couple of months to strengthen your knowledge of ICD-9.  I am certain it will make your day-to-day coding easier now and your transition to ICD-10 much smoother in the future.