Can ICD-10 information lead to better patient care?

Carl Natale
by Carl Natale

Time Magazine actually has a decent article on the ICD-10 debate. I'm surprised because it doesn't rely on flaming water skis or walking into lamp posts to make a point.

It recognizes the high cost of ICD-10 implementation as a deterrent. But Ricardo Martinez, an emergency room doctor at Grady Memorial Hospital in Atlanta, says “Right now, [physicians] just see it as a burden instead of a benefit. But unless you have better information that’s more descriptive, you’re always going to be at a loss to provide better care.”

The article also says that ICD-10 codes are needed to create new reimbursement models based upon the overall health of patients.

ICD-10-CM: 5 Things Physicians Should Know to Prepare

Sandra Draper, RHIT, CCS, director of education and development at Precyse, lists five things that physicians need to know about ICD-10 coding. The first four help explain why there are so many more ICD-10 codes than ICD-9 codes:

  1. Laterality is a factor in most diagnoses and almost doubles the number of codes.
  2. Much more specificity is required to identify the location of an injury or condition.
  3. There are hundreds of combination codes. (Make sure documentation supports all elements.)
  4. The most common misunderstanding about ICD-10 coding is specifying the encounter that the physician has with a patient (not the patient has with a lamp post or turtle).
    • "An initial encounter is one in which the patient receives initial active treatment."
    • "A subsequent encounter is one in which a patient receives routine care during the healing or recovery phase."
    • "A sequela encounter is one in which a patient receives treatment for complications or conditions that arise as a direct result of a condition."

The fifth explains how much valuable information is in the coding guidelines. (Kareo)

Steep climb to ICD-10 readiness

Ken Bradley, vice president of strategic planning at Navicure talks about what small medical practices need to do:

  • Break it down into small, manageable chunks.
  • Don't count on any more delays.
  • Use practice management systems and clearinghouses to mitigate productivity loss.
  • Understand each medical practice needs unique plans.


For Providers, Revenue Assurance through the ICD-10 Transition is Key

Vik Anantha, vice president of Financial Management Solutions at Edifecs, talks about how to mitigate the financial risk that comes with DRG shifts:

  • Use historical data to identify high-risk diagnoses
  • Focus ICD-10 training and CDI efforts on those risks
  • Create “reality-based” maps
  • Allocate resources based on these risks
  • Test solutions


How ICD-10 will benefit physicians

  1. "Grow compensation and reimbursement."
  2. "Determine severity and prove medical necessity."
  3. "Ensure your strong reputation."
  4. "Reduce the hassle of audits."
  5. "Gain access to better clinical information."


Preparing for ICD-10 Requires Leadership, Communication of Benefits

Pretty standard, broad piece on ICD-10 implementation but it does have an interesting quote from Chris Powell, president of Precyse:

"ICD-10 gives physicians and hospitals better information about patient populations for use in quality and outcomes programs to help improve patient health, while allowing them to be appropriately reimbursed for the care provided. So, while providers do have to make an investment in this, the payoff should be equally as significant for a health system over time."

(Beckers Hospital Review)

AHIMA, CHIME partner on governance, health IT, ICD-10

American Health Information Management Association (AHIMA) and the College of Healthcare Information Management Executives (CHIME) announce a strategic partnership that will research areas such as ICD-10 readiness. (Government Health IT)

ICD-10 Survey Findings - July, 2013 - Survey

A new survey finds healthcare providers expect significant problems with the ICD-10 transition and lower reimbursements. (eHealth Initiative)

PAHCOM and CMS continue ICD-10 collaboration

The Professional Association of Health Care Office Management (PAHCOM) and the Centers for Medicare and Medicaid Services (CMS) offer a series of educational opportunities to help small physician practices prepare for ICD-10 implementation. (PhysBizTech)