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ICD-10 Here & Now

As we pass the ICD-10 deadline we find all healthcare to be in a very uncertain and cautious state regarding the implementation and transition to ICD-10 which will be the biggest change in the healthcare industry in more than 30 years. The entire logic of medical diagnosis’s is expanding and becoming more complex. Presently, ICD-9 consists of around 13,000 codes while ICD-10 will be expanding to over 68,000 new codes. Furthermore, the new ICD-10 will be more complex with laterality and specificity. For example with ICD-9 you could bill a claim with a diagnosis as simple as fracture finger. With ICD-10 the dictation has to be very specific such as: Nondisplaced fracture of the distal phalanx of the left ring finger. Here we see two problems in that the physician clearly needs to be very specific with the EMR regarding dictation. All elements of the visit must be noted such as laterality and episode of care such as initial versus subsequent visits. Also a clear understanding of anatomy must be dictated so the insurance processor has a vivid picture of the visit. At the clinic level all support staff needs to be keenly aware the new requirements of ICD-10.

Despite recent reports that physicians practices are falling behind in ICD-10 implementation, the transition should be more simplified than those of large hospital institutions and large health insurance companies. Physician practices will not need to have a working knowledge of 68,000 codes but more likely adopt a few dozen. There are a few key measures that practices may take to make for a smoother transition. First, make sure you’re billing software and claims clearinghouse are up to date and ICD-10 ready. Second, make sure you have adequate training on clinical documentation and process. Lastly, make sure you use the vast amount of resources available online such as ones offered by AAPC and the Centers for Medicaid and Medicare.

The road to ICD-10 may seem rocky and undefined, but utilization of the appropriate tools and education will ensure a smooth transition. At Medorizon, we have over 400 providers that we are currently assisting in their ICD-10 transition. We would certainly welcome the opportunity to assist you and yours. 

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Article Contributors - Medorizon, Tim Tobin, John Miller