Keep your practice’s reimbursements flowing with a seamless transition to ICD-10.  Trained experts with AFMC and the Arkansas Department of Human Services, Division of Medical Services (DMS) will continue to assist providers with resources as they prepare their practice for the ICD-10 conversion. Oct. 1 is the deadline for implementation of the new and updated terminology for coding clinical conditions and patient status. Claims using ICD-9 coding and sent in after Oct. 1 will not be paid.

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If you were unable to attend one of the recent ICD-10 Town Hall meetings, you may view the presentation and slide deck. They have been posted on the UAMS Learn on Demand website. You must create an account to view the video. It’s an easy process taking less than five minutes.

Why ICD-10 is better

Although there has been some resistance (and four years of delays) to adopting the new coding system, much of the increased specificity of ICD-10 is already being captured in common clinical documentation. The 35-year-old ICD-9 only provided limited choices to describe an illness, injury, symptom or condition. Some of it included outdated and obsolete terms that are inconsistent with current medical practice. ICD-10 provides about 140,000 choices of diagnosis codes.  Codes specifically for procedures will expand from about 4,000 to nearly 72,000. However, about half of the increased specificity of ICD-10 reflects left or right side of the body (laterality). That has long been a part of good clinical documentation, according to Sue Bowman, with the American Health Information Management Association, in a July interview with Health Leaders Media. Bowman says the increased specificity also covers disease severity and anatomic site, both consistent with good clinical documentation.

Bowman also says the majority of additional clinical detail, code language and new codes were proposed by physician groups. The International Classification of Diseases (ICD-10-CM) coding system was developed and will be maintained by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention (CDC). The ICD-10-PCS coding system was developed and will be maintained by the Centers for Medicare and Medicaid Services (CMS). Both CMS and CDC updated the coding systems in an open public process, involving clinicians nationwide.

Much of the expanded detail was in response to the need for better and more detailed data, according to Rhonda Buckholtz, AAPC vice-president of ICD-10 training and education. Quality data depends on the quality of documentation at the clinical level. More specific coding that replaces ambiguous code titles should make coding easier, Buckholtz says, emphasizing that providers will likely use only a small subset of codes that apply to their patients and practice.

Will improve patient care

Bowman said there are several improvements in patient care that will result from ICD-10 implementation. The enhanced coding detail available from ICD-10 will produce better and more comprehensive data. Better data means:

  • Better patient care, improved outcomes and patient safety
  • More detail about patients’ conditions, which can help identify high-risk patients who require more intensive resources and improve chronic disease management
  • Better coordination of patient care across providers and over time
  • Increased patient and family engagement by helping guide patient choices about their care
  • More accurate research that can lead to better management of population health
  • Improved ability to assess the effectiveness and safety of new medical technology
  • Enhanced justification of medical necessity for services, reducing the number of denials and appeals

Public health will also benefit from ICD-10 implementation by advancing public health research, surveillance and emergency responses through detection of disease outbreaks and adverse drug events. It will also support innovative payment models that drive quality of care and enhance fraud detection efforts.

To make coding and documentation easier, Bowman suggests using computer-assisted coding technology and electronic health record templates and prompts.