Health Information Management

Tips and hints for achieving physician engagement in ICD-10-CM/PCS

JustCoding News: Outpatient, January 25, 2012

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by Gloryanne Bryant, RHIA, RHIT, CCS, CCDS

We hear about physician engagement across and throughout all healthcare settings almost daily. This is not new, but certainly with ICD-10-CM/PCS preparation, facilities and practices need engaged physicians.

Engagement has many meanings and applications, but for the purpose of ICD-10-CM/PCS, the one that best fits, is the act of sharing in the activities of a group. You may struggle to obtain this type of engagement, but you need to build it into the readiness and implementation plan for ICD-10-CM/PCS. The fact is that ICD-10-CM/PCS is different and it is a very large change that affects and impacts many, including physicians.

Importance of physician engagement
According to, organizations with high levels of physician engagement exhibit the following positive outcomes:

  • Receive higher revenue and earnings per admission and per patient day
  • Increase referrals from engaged physicians
  • Reduce physician recruiting costs
  • Sustain significant growth and profitability

"The physician needs to engage in the process,” Kelly Caverzagie, MD, an academic hospitalist in the division of hospital medicine at Henry Ford Hospital in Detroit says, defining that engagement as “active enrollment and doing it for the right reason.”

To achieve engagement, you must be able to articulate the benefits and reasons for the switch to ICD-10, which includes patient care, quality, and safety, to physicians. We know that some physicians are not convinced of the need for ICD-10. Some even are calling for a delay in the implementation. Recently we heard of the AMA delegates voting to “work vigorously stop the implementation of ICD-10.”

It’s obvious from these statements that we need better communication and increased understanding within the industry about the benefits of the new code sets across the continuum. Many experts on the new code set can assist with the messaging and communication efforts to engage physicians and their associations and societies.

Current and future documentation concerns
I recently attended a compliance conference and one of the physician speakers discussed gaining buy-in from physicians. He spoke about the need to understand their perspective and their challenges. He also talked about the number one issue they face today—not just with ICD-10-CM/PCS in the future—and that is documentation. Physicians need to provide documentation for:

  • Patient care
  • Quality
  • Safety
  • Reimbursement
  • Severity and acuity data

The list goes on and on. We can’t leave physicians out of the loop when it comes to ICD-10-CM/PCS because the documentation once again is at the center of accurate coded data. Engaging physicians around documentation issues is not easy and it will take a lot of effort due to the fact that this is not seen as a priority to the physicians day to day patient care functions.

Tips for engaging physicians
Here are some tips that might provide some direction and insight into your engagement and readiness efforts:

  • Develop an “ICD-10-CM/PCS Awareness” set of Microsoft® PowerPoint® slides or material. Keep it short, simple, and share this with your physicians. Request 10 minutes at a medical staff meeting to present this information. As a bonus, invite the physician office staff to participate. This will increase an understanding of the scope and impact of ICD-10. Engagement of the physician office staff is also critical to success and collaboration.
  • Create some documentation and coding examples using ICD-10-CM/PCS terms and codes. Post these and make them visible to your medical staff. This may be part of your overall educational plan. Remind physicians that ICD-10-CM is simply an extension of ICD-9-CM with added specificity for laterality and several other relevant clinical details.
  • Communicate with your hospital medical staff office and ask to publish some regular ICD-10-CM/PCS articles and/or information in the medical staff newsletter or bulletin over the next 18 months to two years.
  • Invite and include physicians who code today to attend your educational programs and other offerings.
  • Identify, invite, and include physicians on your ICD-10-CM/PCS implementation committee. If you can, appoint a “physician ICD-10-CM/PCS champion” who will help with communication to other physicians and lead many physician related activities surrounding ICD-10.
  • Share and provide any tools that you can with your physicians. Look at your EHR and see if you can add any quick enhancements, electronic templates, and/or reminders to help with documentation specificity. If you are still in the paper medical record world, look at templates that might be useful. This will ease the anxiousness that exists regarding ICD-10. This may be an extension of your current documentation improvement activities.
  • Offer to conduct a documentation assessment and provide the findings to your physicians. Target clinical specialty areas (e.g., orthopedics) to narrow the focus and get to the areas of ICD-10-CM/PCS with the most changes.
  • Join forces with clinical documentation improvement (CDI) and other health information management (HIM) professionals in your physician engagement activities and efforts. ICD-10-CM/PCS expertise lies within HIM so offer to help with physician awareness and their implementation plan as well.
  • Always present the facts and give data whenever possible. Run some reports on diagnoses that are not elsewhere classified (NEC) and not otherwise specified (NOS); this might help you see a pattern or trend.
  • Always be open to suggestions, be responsive to questions, and try to be as available and as accessible as possible. Being known as the ICD-10-CM/PCS resource to your physicians will help with engagement.

Include physicians as much as you can in your ICD-10-CM/PCS implementation plans. ICD-10-CM/PCS increases specificity and granularity, thereby providing better diagnostics and targeted treatment of illnesses, which benefits all of healthcare in the long run. Being prepared takes organization and planning, which will frankly be pivotal to success with ICD-10, so don’t wait; engagement is your calling card as we move into 2012!

Editor’s note: E-mail questions to Senior Managing Editor Michelle Leppert, CPC-A, at Bryant is the regional managing director for HIM for a large, multihospital system in California.

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