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The World Health Organization’s ICD-10 manual has 21 chapters, but your staff will most likely only use a few of them. You’ll also need to decide what resources to use: Do you have an ICD-10 expert on staff who can teach others, or will you find a qualified instructor outside of your practice?
It also helps if you can identify an ICD-10 champion, someone who understands ICD-10 well and has good project management skills, within your staff.
For more tips on identifying your practice needs and preparing your staff, listen to the Training for ICD-10 success webinar.
Greenway is focused on exceptional service, delivered by a team of more than 1,800 clinical practice, financial and technology experts dedicated to innovations that keep people healthier and happier. All of Greenway Health’s solutions and services are designed to meet our companywide goals of serving physicians, connecting the industry and empowering better care. Here you will find the most current information from the CMS on the ICD-10 Diagnosis Codes Transition.
Implementation of ICD-10 diagnosis codes will vary a great deal by the size and type of organization. Coders in physician practices will need to learn ICD-10 diagnosis coding only, while hospital coders will need to learn both ICD-10 diagnosis and ICD-10 inpatient procedure coding. A communication and awareness plan ensures that all your internal and external stakeholdersa€”that is, everyone on your staff and everyone that you do business with who is affected by the ICD-10 transitiona€”understands their responsibilities for ICD-10 implementation. The size of your practice will determine how much planning and documentation will be necessary. Our consultants can help you get ready for the ICD-9 to ICD-10 transition by training you on the general equivalency mappings for codes you commonly use today, ICD-10 coding training for your specialty and the documentation requirements for ICD-10 implementation. If you need help with transition in your office, one of our consultants can help with your practice analysis for ICD-10 readiness and train your staff.
Our medical billing staff can also take over your medical billing, alleviating the stress and expense to get your billing department up to speed.
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.



In the mid 1990's the National Center for Health Statistics (NCHS) found that a clinical modification of ICD 10 Codes would be a significant improvement which should be implemented in the United States. ICD 10 Codes will also improve claims processing and payment, and, through the use of health care technology that utilizes ICD 10 Codes, assist health care practitioners in making treatment decisions by more precisely matching diagnoses and procedures to the appropriate code. On September 22, 2003, the American Health Information Management Association (AHIMA) and the American Hospital Association (AHA) concluded a field-test study of ICD 10 Codes medical code sets. We've created a set of tasks specifically for the ICD-10 transition, to give you a clear picture. Monitor release communications to stay informed about the functions associated with ICD-10. We closely monitor the results of all testing and claim performance on an ongoing basis, in order to minimize the financial and procedural impact of ICD-10. We initially only sent Promaestro the basic demographic entry function, which they picked up on very quickly.
A successful transition hinges on their ability to understand the new coding system and prevent errors that could lead to reimbursement delays or denials. Determine exactly what your practice needs in order to prepare for the transition efficiently.
Not everyone in your practice will need training, and those who do will need it to varying degrees, depending on their role. For some practices, group training may be an efficient solution; others may require one-on-one training. Assess the availability of your staff members and the needs of your practice to determine the best times to train staff members without interrupting normal practice operations.
Will all training sessions take place in person or will Web- or software-based training suffice? Help your staff understand why it’s important to learn this new coding system by explaining the benefits of ICD-10, including how knowing the new codes will help avoid billing errors and delayed payments, and that the extra detail will give analysts and researchers better data that will ultimately lead to improved health outcomes. We connect providers to the right information and insights, at the right place and time, so they can make patient-driven care a reality while navigating the ever-changing healthcare system. Comprising 10 percent of the ambulatory HIT market, we partner with over 10,000 organizations and 75,000 progressive providers across more than 40 specialties, which translates into more than 100 million lives that are touched by our solutions. Whether as a customer, strategic partner or staff member, we invite you to partner with us to create a smarter healthcare system. The larger healthcare providers -- eg, hospitals, hospital-based systems, and even clinic provider organizations -- have more sophisticated systems that need to be remediated and more work that needs to be done than smaller medical practices, but they also have a greater number of resources, including administrative personnel. Healthcare organizations, from large national plans to small provider offices, laboratories, medical testing centers, hospitals and more will need to devote staff time and financial resources for transition activities.
Take into account that ICD-10 coding training may be integrated into the CEUs that certified coders must take to maintain their credentials.
The nature of these changes will vary based on each practicea€™s individual contracting arrangements.
She suggested reading the AHA’s FAQ for tips on formulating questions that the Clinic can answer. As medical knowledge has increased including emerging diseases, new concepts and the need to expand distinctions for managed care and ambulatory care, a clinical modification was needed.
These findings indicated that the ICD 10 Codes represented a significant improvement over the current ICD 9 Codes coding system. Under ICD 10 codes, information about medication errors and external causes of injury will be embedded in the code for the condition. Your clinicians, for example, may not deal directly with the new codes, but they will need training on the more detailed clinical documentation required to code accurately.


A strategy that aligns with the needs of your staff will go a long way toward ensuring they understand and retain the information. Consider whether you want to schedule extra staff to cover those who are in training, hold training sessions during non-business hours or block off a few hours at the end of the day where no patients will be scheduled. Answering questions like these will help you pinpoint the resources you need for an effective transition to ICD-10. You could offer a free lunch or a gift card — just make sure the incentive generates enough excitement to motivate your staff. Smaller healthcare practices may face more challenges in obtaining the information or resources they need about the ICD-10 diagnosis codes, but they will also, at least to some degree, have less work to do than the larger organizations. Physicians should include ICD-10 in their payer contract negotiation discussions to decrease the risk of compliance errors and claims denials.
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. The study also added that the ICD 10 Codes can be implemented without changes in documentation practices or excessive staff training costs. Therefore a single, more informative code will provide a ready source of information to help medical professionals prevent medical errors and improve quality of care. Regardless of their size, the bottom line for all organizations is that all providers need to start planning now for the ICD-10 diagnosis codes implementation.
During the transition period following ICD-10 implementation, payers will continue prior reimbursement policies. 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). The first phase developed with the assistance of a technical advisory panel (TAP) being a prototype. However as the implications of the expanded, more detailed code sets become apparent, payers may also institute policies that involve greater payment for more complex cases and lower payment for less complex cases. The next two phases incorporated enhancements to the prototype based on the ICD 9 Codes Coordination and Maintenance Committee and public input. As previously noted, challenges with billing productivity combined with potential payer claim processing challenges may result in significant impact to cash flow. This may require the need for reserve funds or lines of credit to offset cash flow challenges. As potential problems are identified during the field testing, future improvements are expected. Although ICD 10 Codes are in the public domain, neither the codes nor the code titles can be changed unless approved by the Coordination and Maintenance process overseen together by the Centers for Medicare and Medical Services (CMS) and the National Center for Health Statistics (NCHS). The classification of factors influencing health status and contact with health services (V codes), and the classification of external causes of injury and poisoning (E codes), are incorporated within ICD 10 Codes instead of being considered supplementary classifications, as in ICD 9 Codes.



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