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— Alex Baskous, MD, Anchorage, Alaska


The ICD-10 Transition and “The Animals”

EHR ICD-10 Series

I bought my teenage daughter a record player and vinyl records during the holidays. I still have some of my favorites which I shared with her. I was singing some Animals’ songs and thought of the ICD-10 transition after hearing, “it’s my life and I’ll do what I want—it’s my mind and I’ll think like I want” ("It's My Life"). 

As the documenting physician, it’s your workflow and you can do what you want, but you must code in ICD-10 if you want to get reimbursed. Here are some steps you can start taking today in preparation for the transition:  

Brush Up on Clinical Documentation Improvements

·       Familiarize yourself with new documentation guidelines. For example, ICD-10 combines intrinsic or extrinsic asthma into one category, Asthma. The new codes are based on the severity of the asthma: mild intermittent, moderate, or severe persistent asthma. Staying aware of new guidelines will help you be better prepared for the transition.

·       Look at your most recent encounter and evaluate your documentation for thoroughness and completeness. Also assess and make note of specific documentation pitfalls so they don’t carry over with the transition.

·       It can be helpful to take advantage of online resources - check out AHIMA for some Clinical Documentation Tips

·       Don’t be surprised by clinical terminology changes – listed below are a few examples:
-Senile > Age-related
-Intermediate coronary syndrome > Unstable angina
-Acute myocardial infarction > ST elevation (STEMI) or non-ST elevation (NSTEMI) myocardial  infarction

·       If you want a challenge, look at fractures. In ICD-10, approximately 50 percent of the codes are related to the musculoskeletal system. When coding fractures, you should capture laterality and type of encounter. You can also specify the fracture type, anatomical site, displacement status, etc.

 Identify Your Most Used Codes

·      Determine how and where you currently assign ICD-9 codes and how ICD-10 will impact the assignment of codes. This will be a key component in your preparation for the transition.To generate a list of your most frequently used ICD-9 codes in Amazing Charts, follow the steps listed below:
-Reports > Category = Billing & Coding > Field = Most Frequently Used Diagnosis Codes > Click  "Add Criteria to query" > Click “Run Report”

·      Get a good grasp on the new codes that will impact you the most – you can start by compiling a list of your top 50 diagnoses and coding them in ICD 10. Take advantage of ICD-10 online resources, such as ICD10data.com – this site allows you to input a diagnosis and search for the most appropriate code.

Take charge of your preparation for the ICD-10 transition so in October you aren’t singing, “Oh, mother, tell your children not to do what I have done” ("House of the Rising Sun"). 

Interested in learning more about how to prepare for the transition? Click one of the links below to view the other posts in our ICD-10 series! 

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