Health Information Management

Get your ICD-9-CM coding right to prepare for ICD-10

HIM-HIPAA Insider, June 23, 2014

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I recently spoke with Barbara Hinkle-Azzara, RHIA, vice president of HIM operations for HRS Coding in Baltimore about preparing for ICD-10 and, more specifically, about the anticipated MS-DRG changes associated with the new coding system.

 
During some initial reviews, Barbara and the HRS team saw roughly a 10% change in MS-DRG assignment from ICD-9-CM to ICD-10-CM. Part of that change was because facilities weren’t coding correctly in ICD-9-CM and ended up at an incorrect MS-DRG.
 
Once they corrected the ICD-9-CM errors and arrived at the correct MS-DRG, Barbara and her team saw the MS-DRG change drop to 2-3% different.
 
When was the last time you really validated your MS-DRG assignment? If you aren’t getting to the right MS-DRG now, one of two things will happen when you get to ICD-10-CM. Either you will still end up with an incorrect MS-DRG assignment (putting you at risk for audit takebacks) or you will see a larger-than-anticipated change in MS-DRG assignment in ICD-10-CM (which means you could gain or lose money and your case-mix index could change).
 
Validate your current coding and MS-DRG assignment. If you find problems, look for the root cause. Is it poor documentation? Are coders missing documented information in the record? Are coders incorrectly applying guidelines?
 
Fix those problems now or they will continue to grow in ICD-10-CM.
 
This article originally appeared on HCPro’s ICD-10 Trainer blog.

 



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