Case Management

ICD-10 is coming - Are you ready?

Case Management Insider, September 1, 2015

While many people thought, or hoped, that ICD-10 would be delayed again, experts say it’s really happening. The change from ICD-9 to ICD-10 will occur on October 1, and case managers should take steps to understand the change and how it will affect their role.

Whether it will have a large or small effect on your job will largely depend on how your role is structured, says Stefani Daniels, RN, MSNA, CMAC, ACM, founder and managing partner of Phoenix Medical Management, Inc., in Pompano Beach, Florida.

Either way, you must get ready for the switch.

Under ICD-10, documentation requirements will be different. The change doesn’t increase the amount of documentation that physicians need to do, but it will make it more important for them to be more precise when they are detailing a case. Case managers should know enough to be able to educate physicians about this new level of clinical specificity, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, PCS, FCS, CPUR, C-CDI, CCDS, CDI Manager at Adventist Hospital in Rockville, Maryland.

ICD-10 also redefines certain conditions, another fact that case managers should be aware of and informed about, says Daniels.

For example, there is no more “congestive heart failure.” Instead, physicians will need to cite “left ventricular failure,” she says. Case managers needs to know enough about these revisions to remind physicians who see a large volume of patients with conditions that will require greater specificity or have been redefined.

Case managers should also be alert for changes and revisions to ICD-10 going forward.

For additional information or resources to help ensure you are up to speed with ICD-10, check out the ICD-10 Quick Start Guide or the Road to 10, which may be a good resource for small physician offices that work with your organization.

For more detailed information about the changes brought by ICD-10 and to get insider tips and tricks on how to comply, check out the October issue of HCPro’s Case Management Monthly.

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