In the wake of the latest ICD-10 implementation delay, coders and other healthcare professionals are looking for ways to continue with their implementation and training. They are also looking for ways to minimize the disruptions the delay may cause.
Plenty of uncertainty surrounds the ICD-10 implementation delay, but healthcare organizations shouldn’t put the brakes on their plans. Cheryl Ericson, MS, RN, CCDS, CDIP , William E. Haik, MD, FCCP, CDIP , Monica Lenahan, CCS , Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and James S. Kennedy, MD, CCS, CDIP, offer thoughts on how to keep moving forward with ICD-10.
ICD-10-CM includes more specificity than ICD-9-CM, but it still includes unspecified codes. Adele Towers, MD, MPH, Joanne Schade-Boyce, BSDH, MS, CPC, ACS, PCS, Michael Gallagher, MD, MBA, MPH, Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC , and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, explain when reporting an unspecified ICD-10-CM code is a good option.
ICD-10-CM provides many more combination codes for drug- and alcohol-related diagnoses than ICD-9-CM. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, explains how this could actually result in less work for coders.
CMS posted updated versions of all the guidance documents posted on the Inpatient Hospital Review site. The agency also posted a new document reviewing the status of the probe and educate audits, including examples of some of the errors the MACs have found in audits thus far.
Some of the most significant changes in cardiovascular coding in ICD-10-CM involve coding for myocardial infarctions (MI). Laura Legg, RHIT, CCS , and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, review new guidelines and specificity involved in ICD-10-CM MI coding.
Coders may struggle to differentiate between ICD-10-PCS root operations Excision and Resection. Nena Scott, MSEd, RHIA, CCS, CCS-P, AHIMA-approved ICD-10-CM/PCS trainer, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, illustrate the details that will help coders arrive at the correct root operation.
Coders and clinicians seem to speak different languages. CDI specialists often serve as the translators between clinicians and coders, so it's important that all three groups work together. Cheryl Ericson, RN, MS, CCDS, CDIP , AHIMA-approved ICD-10-CM/PCS trainer, Darice M. Grzybowski, MA, RHIA, FAHIMA , Jonathan Elion, MD, Kathy DeVault, RHIA, CCS, CCS-P , and William E. Haik, MD, FCCP, CDIP , offer tips for determining when to query.
James S. Kennedy, MD, CCS, discusses the increased clinical specificity required for coders to report strokes and transient ischemic attacks in ICD-10.
Coders may struggle to differentiate the ICD-10-PCS root operations excision and resection. Nena Scott, MSEd, RHIA, CCS, CCS-P, AHIMA-approved ICD-10-CM/PCS trainer, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, explain why excision is the root operation of choice for excisional debridement and sebaceous cyst removal.
When it comes to coding malnutrition, coders need to see very specific information in the physician documentation. James S. Kennedy, MD, CCS, William E. Haik, MD, FCCP, CDIP , and Mindy Hamilton, RD, LD, review the clinical factors for malnutrition and how to assign the correct ICD-9-CM codes.
CMS will conduct full end-to-end testing—from submission to remittance advice—with a select sample of providers in July. CMS first announced the decision in MLN Matters® SE1409 and provided additional details during the February 20 webcast, CMS ICD-10 Readiness.
Heather Taillon, RHIA, Cheryl Collins, BS, RN , and Andrea Clark, RHIA, CCS, CPC-H , explain the basic rules regarding principal diagnosis selection in general and for neoplasms in particular in ICD-9-CM.
Coders may need to have a conversation with physicians about how changes in ICD-10-CM could require additional documentation for mental disorders due to a known physiological condition. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , AHIMA-approved ICD-10-CM/PCS trainer, compares coding for these conditions in ICD-9-CM and ICD-10-CM.
Inpatient coders will have a new coding system on October 1, but they won’t have to learn new MS-DRGs. They aren’t changing. However, coders will see some shift in MS-DRG assignment in ICD-10. Donna M. Smith, RHIA, and Lori P. Jayne, RHIA, reveal why the MS-DRG shifts will occur.
