Health Information Management

News: Oncology study shows loss of data capture under ICD-10

CDI Strategies, March 27, 2014

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The transition to ICD-10-CM will result in a “significant information loss”, according to a new study published in the February Journal of Oncology Practiceby the American Society of Clinical Oncology.

The study points to prior indications that hematology-oncology could be among the least affected specialties but after mapping more than 100 top codes, results seem to indicate that translation errors could affect up to 5% of a practice’s Medicare billing—which could “evaporate the operating margin of a practice.”

Rather than demonstrating a true data loss, the study may actually be illustrating the lack of effective “mapping” tools, says Carl Natale of ICD-10 Watch. “What this study does show is that relying on automatic mapping tools or translators will result in a reduction of information and reimbursements,” Natale writes.

Working through actual medical records to test coder effectiveness is a vital piece of program preparedness, says Mark Lott, principal of Lott QA Group, who is conducting national testing of the new code set. Canned scenarios are not optimal training tools, he says.

And don’t rely on the general equivalency mapping systems, or GEMs, to do the work for you. “You need to make sure that coders are using the codes the right way, not just mapping the codes,” Lott says.

Editor’s Note: Read more about ICD-10 implementation in the CDI Journal article “Implementation year begins with dual coding.”

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