Health Information Management

Don't let draft designation derail your ICD-10 education

HIM-HIPAA Insider, November 17, 2014

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You may have noticed that the ICD-10 manuals have the word “draft” splashed all over them. (If you have an actual paper ICD-10 manual that is. The PDFs don’t include the word draft.)
I had someone ask me about the word “draft.” She wanted to know when the draft designation would be removed so she could starting learning ICD-10.
I asked her why she was letting the word draft stop her from learning ICD-10. She said she wanted to wait until the code sets were final before she started memorizing codes.
I was, quite literally, speechless at that pronouncement.
First, the code sets are never going to be final. We had yearly updates to ICD-9-CM even after we had been using it for 20 years. We’ll get yearly updates to ICD-10 starting one year after implementation. Medicine changes all of the time, and so do codes.
Second, that draft designation is not going away until we actually start using ICD-10. If you wait until October 1, 2015, to start learning ICD-10, you are in big trouble.
Third, you should not be setting out to memorize codes. I know coders can recite codes they commonly use off the top of their heads. I have seen some very impressive displays of coding from memory. That doesn’t mean it’s a good thing. Did I mention that codes change? And so do coding guidelines. Also I’m not sure anyone sets out to memorize codes. It’s more a retention due to repeated use phenomenon. For example, I think every coder knows 250.00—diabetes unspecified. Not because we set out to learn it, we’ve just seen it so many times.
I’m not sure you could actually memorize most ICD-10 codes, especially the PCS codes. Good grief, some of those tables have a hundred possible combinations and you have to make sure you’re in the right row. I don’t know how you could keep everything straight.
No doubt coders will start picking up the diagnoses they report all of the time. Pretty soon everyone will know E11.9 (the ICD-10-CM version of 250.00).
Instead of memorizing the codes, learn the concepts that ICD-10 is introducing. Make sure you understand what the seventh character represents and when you use an A, or a D, or an S. Check out the new guidelines (most are the same in ICD-9-CM and ICD-10-CM, but there are a few differences).
If you are an inpatient coder (or an outpatient coder who will be using ICD-10-PCS), you have a lot to learn. ICD-10-PCS is completely different from ICD-9-CM Volume 3. That’s not meant to scare you. For the most part, PCS makes sense. It’s just not what you’re used to doing. Get familiar with the information required to build a PCS code, then start reading through your physicians’ documentation to find out where that information is.
Start a dialogue with your physicians and clinical documentation improvement specialists now to make sure everyone understands the new concepts in ICD-10. Work for an OB practice? You’ll need to start looking for weeks of gestation and make sure the docs are documenting it. Code orthopedics? You’ll need to brush up on your anatomy because the codes are much more specific. Be sure you tell the physicians they need to indicate a more detailed anatomical location if their current documentation isn’t detailed enough.
We have a lot of work to do in a shrinking time frame. Don’t let something like a draft designation derail your training and transition plans.
This article originally appeared on HCPro’s ICD-10 Trainer blog.


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