In case you missed the news, ICD-10 has been delayed a year. It’s likely that we’ll be taking a break from talking about ICD-10 for the next 6-10 months. However, before we put ICD-10 on the shelf, you might want to read two opposing arguments for and against ICD-10: The Forgotten Argument For ICD-10 and Why ICD-10? Plus, below is a guest blog post by Heidi Kollmorgen, Founder of HD Medical Solutions, putting some perspective on where we’re at with coding. She has some good insights I hadn’t heard before. I’ll probably wrap up this series on ICD-10 with a look at what organizations should do now that ICD-10’s been delayed.
Many people who don’t understand the value of ICD-10 go straight to the “humorous codes” as a reason to justify delaying its implementation or even not adopting it at all. Does anyone realize those codes only make up 67 of the 1583 pages of the 2014 Draft Set?
Those seemingly “useless” codes are stated in the ICD-10 Chapter 21 Guidelines as having “no national requirement for mandatory ICD-10-CM external cause code reporting”. External Causes of Morbidity codes “are intended to provide data for injury research and evaluation of injury prevention strategies” only.
The *real* ICD-10 codes are more specific and allow greater accuracy for clinical data purposes. Many would agree that patient safety and effective and timely patient-centered care are the goal of most healthcare providers. Clinical data gathered and analyzed is what allows this to be achieved and ICD-10 codes are critical for more accurate analysis (1).
ICD-9 was adopted and went “live” in 1979 – how many advances has medicine made since that time? The ICD-9 code set does not allow doctors to accurately identify how they are treating patients any longer, nor does it allow accurate reporting of the services they provide to their patients. In 2003 the NCVHS recommended the adoption of ICD-10 and fourteen years later providers still claim they haven’t had time to prepare (2).
Doctors and other healthcare professionals who choose to take advantage of the daily barrage of free ICD-10 training and education from CMS and countless other sources for themselves and their staff will not go out of business. Providers who recognize that hiring an educated and/or certified medical biller/coder is an investment with huge ROI potential.
Those individuals have the training and ability to prevent and decrease denials and rejected claims from the onset when the claims are initially prepared. They also understand the intricacies of carrier guidelines so providers who hire them will never go out of business or suffer from decreased cash flow, rather their reimbursement would improve and they would also be compliant.
The days of hiring your neighbors daughter or friend because they need a job, or because they like working with numbers are over. It shouldn’t be impossible to understand how saving money in overhead and payroll only costs you infinitely more in lost reimbursement. Is the irony lost in correlating the profession of Health Information Management to Nursing? In the history of medicine it was only in the last one hundred or so years that licensing of nurses went into law. http://www.nursingworld.org/history Would any doctor today work with an unlicensed or inexperienced person who claimed to be a nurse? Would any hospital or facility hire someone who applied for a nursing position only because they liked working with people? That’s basically how the profession of nursing began.
In regards to the opinion held by many how ICD-10 codes are outlandish I would agree in some cases. I have a wicked sense of humor and because I know the codes I could create funnier cartoons than any you have come across. The difference is that coders understand how that argument holds no merit and only proves how providers don’t even understand ICD-9-CM. Unfortunately, most are probably using it incorrectly as well and it may be one of the causes of low reimbursement.
Just in case you see a patient today who is a water skier and has an accident while jumping from a burning ship use ICD-9-CM E8304. Have a patient who was knocked down by an animal-drawn vehicle while riding a bike? There’s a code for that too – ICD-9-CM E827.
The good news is how the Guidelines for ICD-9-CM patient encounters are similar to ICD-10-CM for these types of codes. If you don’t typically use them now you won’t when ICD-10 goes into effect either. Providers who document what they did, why they did it and what they plan to do do about it will have no problem switching to ICD-10. Aren’t we lucky nothing has changed about that?
Heidi Kollmorgen is the founder of HD Medical Solutions which offers practice management services for solo and multi-physician groups. She holds AHIMA certifications and is dedicated to optimizing reimbursement by following compliant measures. She can be found at http://hdmedicalcoding.com/ or follow her on Twitter @HDMed4u.