Medical practices need to assess ICD-10 impact

Carl Natale
by Carl Natale
Medical practices need to assess ICD-10 impact

As the first anniversary of ICD-10-CM/PCS implementation nears, U.S. healthcare isn't sure how to assess its impact.

This is attributed widely to the flexibility in accepting Medicare claims that simply had diagnosis codes from the correct family of codes. This "close enough for government work" approach seemed to have been adopted by many private payers that wanted to give small and solo medical practices a break.

Which could be why ICD-10 implementation has had a minimal effect on reimbursements and denials.

But Deborah Zarick and Renee Abda point out that the flexibility and lack of audits has led to less data about the ICD-10 transition.  This means the industry can't offer insights about how to improve performance based upon big data.

Individual medical practices can take a small data approach through self-auditing and tracking. Monitoring key performance indicators (KPIs) and assessing workflow will help keep productivity and quality on track.

Zarick and Abda also offer some specific tips:

  • Cultivate feedback
  • Track issues and take corrective action
  • Use coder queries to educate staff
  • Use clinical documentation reviews to educate staff
  • Share coding educational materials
  • Review use of unspecified diagnosis codes
  • Review systems and upgrades

Medical practices need to understand medical coding is about constantly learning — not just when there are updates.