As time ticks down to the ICD-10 deadline, acting CMS administrator Andy Slavitt announced that William Rogers, MD, a practicing ER physician at Georgetown University Hospital, will serve as CMS’s official ICD-10 ombudsman. During the same provider call, CMS Chief of Staff Mandy Cohen, MD, MPH, discussed the concept of code families, a term used in the July CMS-AMA joint announcement of flexibility in Medicare claims auditing.
Giving an example of an ICD-10 coding scenario, she said the category that covers Crohn disease is K50 (Crohn’s disease of small intestine without complications).
The AMA-CMS accord stipulates that Medicare will process and not audit ICD-10 claims, as long as a valid code from the correct family is used.
Sue Bowman, MJ, RHIA, CCS, FAHIMA, senior director of coding policy and compliance at American Health Information Management Association (AHIMA), and Nelly Leon-Chisen, RHIA, coding and classification director at the American Hospital Association (AHA), reviewed some basics of the ICD-10 implementation. For inpatient facility reporting, “date of service” is the date of discharge, so if a patient was admitted to the hospital on September 20 and discharged on October 1, the claim is reported using ICD-10.
Unspecified codes are still acceptable and often are the best choice, such as in a case where a provider doesn’t have enough information about a condition or the documentation does not support more specificity.

Leon-Chisen said that providers still have time to prepare, but they need to get started immediately, following the five key steps presented in CMS’s ICD-10 Quick Start Guide: Make a plan, train your staff, update processes, talk to your vendors and health plans, and test systems and processes. Leon-Chisen said that anyone can submit coding questions to the AHA’s Coding Clinic; you don’t have to be an AHA member, but you do have to register first (for free).
If you work in a specialty practice, you probably never trained on every single ICD-9 code; no, you learned the codes pertinent to your specialty, and you focused on coding rules you encountered daily. That’s exactly what you get with SuperCoder’s specialty ICD-10 online training courses, with applicable tips and examples, simple explanations, and training techniques proven to promote learning retention. About Susan DooleySusan taught health information and healthcare documentation at the community college level for more than 20 years. She suggested reading the AHA’s FAQ for tips on formulating questions that the Clinic can answer. Cohen explained that “family” is synonymous with the three-character category, and codes in a category are clinically related.

Cohen added, there are some circumstances that could cause a code to be rejected for a different reason, such as the code not being consistent with an applicable policy such as Local Coverage Determinations (LCDs) or National Coverage Determinations (NCDs).
She is passionate about ensuring accurate patient healthcare documentation through education. She has a master's degree in healthcare administration, is a certified healthcare documentation specialist, and serves as immediate past president for the Association for Healthcare Documentation Integrity (AHDI).

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