Beginning October 1st, 2015, ICD-10 will become the standard for medical billing. This means that any claims submitted without the correct coding will be rejected. The International Statistical Classification of Diseases and Related Health Problems (ICD), was developed to make framework for documenting diseases, symptoms, and medical procedures more consistent throughout the industry. While ICD-9 had around 17,000 different codes, ICD-10 has more than 150,000. This increase in codes is due to today’s intricate healthcare environment.
What are the differences between ICD-9 and 10?
There are actually two parts to ICD-10:
• ICD-10-CM – for clinical modification replaces the first two volumes of ICD-9
• ICD-10-PCS – created by the Centers for Medicare and Medicaid Studies (CMS), which replaces Volume 3 of ICD-9.
The ICD-10 codes contain much more information, a single code represents a disease and how it is manifested, and also includes information about laterality (which side of the body is affected). While implementing 150,000 new codes may appear extreme, ultimately, the adoption of ICD-10 will streamline the insurance claim submission process as fewer supporting documents and requests for additional information will be required.
150,000 codes? That is a lot to remember.
Have you ever visited a foreign country? You probably memorized a few key phrases, which was adequate enough to get by if you were only staying a few days. Now, think about moving to that country. Memorizing a few simple phrases wouldn’t be enough. You would have to learn the language. Soon everyone will be “speaking” ICD-10, and a fundamental understanding of this medical language is essential to your facility’s success.
All essential employees including coding and billing staff will need to be trained to use the new software that takes in data and interprets codes. In healthcare facilities with electronic medical records (EMRs), coding and billing professionals will have to learn how ICD-10 codes are used with the EMR software.
Training Will Make a Significant Difference in the Success of Your ICD-10 Conversion
The keys to successfully converting form ICD-9 to ICD-10 are training and hands on experience. The American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA) offer training courses in ICD-10, andCMS has a collection of online resources to help facilities make the transition with minimal disruption. It is imperative that coders maintain their coding certification through continuing education and should be given every opportunity to do so.
Why The Right EMR Makes a Positive Difference
EMRs have great potential to simplify the changeover to ICD-10. However, a low quality EMR system could hinder the transition. Just because a vendor has advised that ICD-10 would be an automatic transition, does not mean staff does note need to be changed. In fact, that couldn’t be further from the truth.
An EMR that offers the following features will help the ICD-10 conversion:
- Access to previous patient visits
- Integrates ICD-10 search capabilities
- Templates that can be customized to prompt users for specific details
- The ability to integrate patient radiology, lab, and pharmacy data into recordsRemember, while an EMR solution will help facilitate a smooth transition to ICD-10, it is also imperative to train the billing and coding staff as well. A medical practice is only as good as it’s staff, therefore training should be treated with the utmost care.