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What About Your Preparations for ICD-10?
Posted: August 21, 2013

What About Your Preparations for ICD-10?

Charles B. Brownlow, OD, FAAO

brownlowod@aol.com

 

October 1, 2014 is the date that ICD-10 will replace ICD-9 for reporting medical conditions in patient records and on insurance claims in the US.  Anyone paying attention to the vendors of educational/informational/training products and services for ICD-10 implementation would think that the changeover will be extremely complicated, the training will be deep and wide, and that it will cost thousands of dollars to get an office converted to the new coding system.

 

Rest assured that ICD-10 is different, very different, completely different than ICD-9.  It offers over 70,000 potential choices for coding diagnoses, causes of medical conditions, etc., compared to about 17,000 choices in ICD-9.  It is the complexity though, that will make the preparation easier.  I know that doesn’t sound logical, but it’s true.  The system is so complex that one will need to rely upon software to aid in the choices.  The software that currently exists already makes the process simple.  In the near future, you will be able to purchase subscriptions for ‘ICD-10 calculators’ that take the guesswork out of the process.  In the near future, offices utilizing electronic medical records systems will have ICD-10 capability built right into the EHR, automatically choosing (or recommending) ICD-10 codes just as they currently recommend choices of ICD-9 codes, based on the content of the patient’s record for the day.  The choice of ICD-10 code will be an automatic, single-entry system, converting the words of the diagnoses into ICD-10 codes.

 

Most ODs receive at least one email a day; unsolicited, of course; from some consulting group offering to train doctors and staff in your practice via webinars, face to face seminars, online consultation, whatever, for the low fee of $295/person, $495/session, $999 for six monthly online sessions with the consultant, etc.  Please continue to ignore those ads, but don’t ignore the need for preparation.

 

Here’s what I suggest you do to prepare your doctors and staff for the October 1, 2014 ICD-10 Implementation:

  • Go online soon and Google ‘ICD-10 calculator’ or ICD-10 preparation.  You’ll see lots of great opportunities for consultants to separate you from your money, but you’ll also find a couple of free ‘calculators.  Log on and test it out.  Type in primary open angle glaucoma, or diabetic retinopathy.  Type in a common ICD-9 code and convert it to the ICD-10 code, etc.  You will be surprised at how well software does the job.
  • Examples: http://www.aapc.com/icd-10/codes/ or http://www.icd10data.com/ .  By entering an ICD-9 code, eg 365.11, the calculator provides the ICD-10 code and description, H40.11XX, primary open angle glaucoma, stage unspecified.  All that’s left to the doctor/staff is to indicate right/left/both eyes where the X appears in the third space after the decimal point, (1=right eye, 2=left eye, 3=both eyes) and to specify the stage as the final digit (0 = unspecified, 1 = mild, 2=moderate, 3=severe, and 4=indeterminate.)

Note: The ‘X’s’ are used as placeholders, indicating that other information is needed to choose the correct code, such as laterality or severity of condition, etc.  

  • Visit the CMS website for more good, practical, unemotional information on this important subject: http://www.cms.gov/Medicare/Coding/ICD10/index.html
  • Call one of your semi-annual monthly staff meetings to discuss ICD-10…January 2014 will be early enough…Seriously.   In the meantime, try to encourage doctors and staff in your practice to concentrate on current challenges and worry about ICD-10 less.  My prediction is that when October 1, 2014 arrives, you will be very happy that you did not obsess over ICD-10 and that you didn’t drop tons of money on training and preparations for the ‘big day’!



  


  


  


  

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