Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

Ring in 2015 – Ring Out MD Myths about ICD-10

Posted on January 7, 2015 I Written By

The following is a guest blog post by Wendy Coplan-Gould, Founder and President of HRS Coding.

Physicians see ICD-10 as a mixed bag of distraction, expense and long-term advantages. They’ve heard grossly exaggerated messages about ICD-10’s complexity and cost. Confusion has led to complacency and obstinacy across physician practices and medical groups.

Conversely, some physician practices and medical groups eagerly await ICD-10’s ability to accurately describe their high-risk patients, improve data mining capabilities, and demonstrate complexity of cases. The opportunity for cleaner data, better quality scores and greater patient safety are three more physician-friendly benefits of ICD-10 as described in my previous ICD-10 post on EMR & HIPAA.

Recent research conducted with a 20-physician focus group, and presented during AHIMA’s 2014 Convention & Exhibit, revealed three common themes with regard to physician perceptions of ICD-10 and its effect on their practices.

Physicians are concerned about the following:

  • How specific their clinical documentation has to be for correct ICD-10 code assignment.
  • Obtaining accurate reimbursement under ICD-10.
  • Receiving ICD-10 training from the hospitals they serve.

With the advent of a new year, now is the time for hospitals and healthcare systems to dispel physician myths about ICD-10 and actively engage practices—one medical group at a time.

Five ICD-10 Realities and Physician Engagement Strategies

Is ICD-10 as difficult for doctors as once portrayed? The resounding answer for 2015 is “no.”

When introduced one physician office at a time, the implementation of ICD-10 is relatively easy. Consider these proven strategies to foster greater physician buy-in for ICD-10.

  • Most physicians will only use a small subset of ICD-10 codes—dramatically decreasing the amount of time required for training and preparation (1-2 days). Target training efforts toward the 80 percent of diagnosis and procedure codes that are used repeatedly within each practice or specialty.
  • When hospitals focus on improving EHR documentation templates, physicians are more productive, efficient and engaged in ICD-10 efforts. Foster inclusion by helping physicians build better documentation templates across all EHR applications.
  • Physicians learn best from other physicians. Find physician documentation champions within each specialty and make ICD-10 learning fun.
  • The best way to minimize claims denials and ensure proper reimbursement for both hospitals and physicians under ICD-10 will be the avoidance of non-specific codes. Focus on helping physicians document better and give them tools such as real-time documentation aides and prompts to create more succinct, accurate and complete clinical documentation.
  • Physician practices must also be included in end-to-end testing for ICD-10. Be sure to include them within your organization-wide testing plans. Even when testing is only for payer acknowledgement, it provides segue for physician practice coding and billing staff to practice submitting ICD-10 codes.

Blaze a New Path with Physicians in 2015

Last year left many hospitals feeling defeated regarding ICD-10 and their physician preparedness efforts. Money was spent and staff resources were exhausted. Congress dealt a devastating blow to ICD-10 budgets, timelines and implementation teams.

But the ship hasn’t sailed. There is still time to actively engage your medical staff in preparing for ICD-10. Erase your original message to physicians that ICD-10 is difficult and expensive. Replace it with knowledge gleaned over the past two years, recent physician research, and new implementation timelines based on specialty.

By focusing on the clinical data advantages of ICD-10 and bolstering physician productivity and efficiency, hospitals can blaze a new path toward the new code set—one practice at a time.

About Wendy Coplan-Gould
Wendy Coplan-Gould is the embodiment of HRS. She has led the HIM consulting and outsourcing company since 1979, through up and down economies and every significant regulatory twist and turn of the last three decades. Long-time clients and new clients alike are on a first-name basis with her and benefit from her focus on excellence, reliability and flexibility. She has been published in the Journal of AHIMA and other recognized publications, as well as conducted countless professional association presentations.

Prior to starting HRS, Wendy served as assistant director, then director, of Health Information Management at Baltimore City Hospital. She also was associate director of the Maryland Resource Center, which provided data for Maryland’s Health Services Cost Review Commission, an early adopter of the Diagnosis Related Group (DRG) methodology. Wendy is available via email: wendy@hrscoding.com.

Five Reasons to be Thankful for ICD-10

Posted on November 30, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest blog post by Wendy Coplan-Gould, RHIA, Founder and President of HRS Coding.

It’s Thanksgiving weekend—a time for reflection and gratitude. Thoughts typically turn to family, friends, health, and life’s many other blessings. In addition to all of these, this Thanksgiving I suggest that the healthcare industry also include ICD-10 in our list of godsends. Here are five reasons why:

Reason #1:  To Code New Diagnosis, Procedures and Devices

The current ICD-9 coding nomenclature was developed in the 1970s. The healthcare industry can’t afford for this same system to be capturing data in the 21st century. We need the ability to specifically code new diseases, procedures and devices. For example, U.S. healthcare providers are unable to precisely code Ebola in ICD-9. That’s true.

There is no specific code for the diagnosis of Ebola in ICD-9, only a general code 078.89, other specific diseases due to viruses. In ICD-10, the code is A98.4, Ebola virus disease. This is the kind of data specificity that our nation needs and ICD-10 delivers.

Reason #2: To Help Keep Patients Safe through Better Data

ICD-10 also helps the healthcare industry capture and track data, and use it to ensure the safety of our patients. The inability to have specific data at our fingertips can be crippling to an institution and result in erroneous decisions based on faulty or imprecise data. Be thankful for ICD-10’s ability to accurately pinpoint diagnoses—and support more precise, exact patient care.

Reason #3: To Reduce Costs

Hospitals are strapped for money. Costs must be reduced whenever and wherever possible. ICD-10 will help hospitals properly bill for the services they deliver. With ICD-10 fully implemented and clinical documentation more granular, hospitals will experience fewer payer denials, claims audits and reimbursement appeals. Valuable time, money and resources will be saved over the long run.

Physician practices also have reason for thanks. New data published on the Journal of AHIMA website earlier this month suggests that the estimated costs, time and resources for offices to convert are “dramatically lower” than original estimates. According to the article, the actual conversion cost for a small practice ranges from $1,900 to $5,900, which is 92 to 94 percent less than initially predicted, resulting in a faster return on investment for your ICD-10 efforts.

Reason #4: To Improve Quality Scores and Performance Rankings

Setting aside zany codes and implementation barriers, ICD-10 is a blessing for quality reporting and performance scorecards. ICD-10’s code granularity works hand in hand with improved clinical documentation across all disciplines to help organizations achieve more accurate quality scores and competitive rankings. This is good news for hospitals and physicians alike.

For example, in ICD-9-CM, there is only one code (427.31) for atrial fibrillation.  In ICD-10-CM, physicians must specify the atrial fibrillation as paroxysmal (I48.0), persistent (I48.1) or chronic (I48.2), providing the specificity for a secondary diagnosis that can affect severity of illness scores and impact quality measures.

Reason #5: To Strengthen Hospital-Physician Relationships

ICD-10 is a bull’s-eye for governmental delay. And physician groups are usually the archers behind Congressional action against ICD-10. As recently as this week, physicians were pushing legislators to delay ICD-10 yet again. However, the tide may be turning.

In an effort to help their laggard physicians, many hospitals are reaching out to assist practices and groups in four key areas:

  • ICD-10 assessments
  • clinical documentation reviews
  • technology upgrades
  • physician-coder education

Helping physician practices with ICD-10 is an olive branch that must be extended to realize the full potential of ICD-10. Savvy organizations are using ICD-10 as a pathway to better hospital-physician relationships. Finally, AHIMA, MGMA and AMA have offered resources specifically designed to clear up common misconceptions and concerns physicians have about ICD-10.

No More Delays

It is estimated that the last delay cost the healthcare industry approximately $6.8 billion in lost investments, not including the cost associated with missed opportunities for better health data to improve quality of care and patient safety as mentioned above. Everyone from CMS to AHA, AMA, MGMA and HIMSS has endorsed the move to ICD-10 on October 1, 2015.

The rallying cry from hospital executives, IT directors and clinical coders is clear—no more delays! Even payers are pushing for the October 2015 date with a new consortium featuring Blue Cross Blue Shield of Michigan and Humana leading the charge. As Dennis Winkler from Blue Cross Blue Shield of Michigan states, “ICD-10 is good for the industry. . . . It is in everyone’s best interest to work together and ensure readiness across the board.”

Be Thankful

In Mitch Albom’s 2009 New York Times best seller, Have a Little Faith, the author asks an 82-year-old rabbi to identify his secret to happiness. “Be grateful” is what the rabbi repeatedly claims to be the only true route to happiness.

So next time your executives, staff or physicians are complaining about the transition to ICD-10, remember the five reasons described above . . . and be thankful.

About Wendy Coplan-Gould
Wendy Coplan-Gould is the embodiment of HRS. She has led the HIM consulting and outsourcing company since 1979, through up and down economies and every significant regulatory twist and turn of the last three decades. Long-time clients and new clients alike are on a first-name basis with her and benefit from her focus on excellence, reliability and flexibility. She has been published in the Journal of AHIMA and other recognized publications, as well as conducted countless professional association presentations.

Prior to starting HRS, Wendy served as assistant director, then director, of Health Information Management at Baltimore City Hospital. She also was associate director of the Maryland Resource Center, which provided data for Maryland’s Health Services Cost Review Commission, an early adopter of the Diagnosis Related Group (DRG) methodology. Wendy is available via email: wendy@hrscoding.com.

Making the Case for Dual Coding

Posted on December 19, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at AHIMA, Healthcare Scene sat down with Kim Carr, Director of Clinical Documentation at HRS. In the following video, I ask Kim Carr to make the case for dual coding. I even assert that many look at dual coding as dual work, but Kim Carr offers a number of important reasons that organizations should be doing dual coding ICD-9 and ICD-10 today.

While dual coding is great for your ICD-10 preparations, it turns out that your organization can benefit from dual coding even under ICD-9. Kim Carr talks about a specific example of benefits you can gain for your organization even before ICD-10 becomes a requirement.

Certainly some organizations struggle with how to do dual coding while still maintaining their day-to-day coding production. This is where an organization may want to look to an outside company to help them through the process.

Considering New Years is just around the corner, maybe dual coding would be a great New Years resolution for your organization.

Check out all of our ICD-10 Tuesdays posts for other related content.