ICD-10 delay provides extra time to improve documentation and education efforts
APCs Insider, September 19, 2014
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By Steven Andrews, Editor
If not for a couple sentences snuck into an unrelated bill at the end of March, CMS would be flipping the switch for ICD-10 in less than two weeks. Would your organization have been ready?
While some organizations could answer a resounding "Yes" or "No," most are probably somewhere in the middle. After all, ICD-10 implementation requires coordination across many departments and organized efforts with physicians, coders, and payers.
As a result of the delay, providers have extra time to ensure they're well prepared for the transition. One area they can focus on is aligning physician documentation with some of the new terms and concepts in ICD-10-CM.
For example, ICD-10-CM includes drug use codes to report underdosing, which was not possible in ICD-9-CM. Using these codes, providers can report whether a patient is taking less of a drug than prescribed or instructed and whether the underdosing is deliberately or inadvertently.
However, physicians will have to know to document this information, and coders will have to know to look for it. In addition, coders will have to know that these are combination codes—they include both the substance that was taken as well as the intent. They don’t need to add external cause codes for underdosing.
Clinical documentation improvement (CDI) specialists can be an important resource for coordinating the clinical efforts that will be needed to aid coders and billers. CDI staff who know the new coding concepts can work directly with physicians on what they need to document. While some of the concepts won't be needed by every department, you should review your top-billed diagnoses in order to see where CDI efforts can be focused.
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