If you can’t figure out the hype about ICD-10…

For most people working in healthcare, October 1 seems to bring about three different expressions – utter dread, excitement or a look that says “eh? What about it?”

October 1, 2014 is the day ICD-10-CM-PCS will go into effect. If you work in healthcare and haven’t heard about this, you are definitely in for a surprise and really should google it or go to cms.gov for more info. This change will affect EVERYONE in the industry, and it affects every person who receives healthcare services as well.

I’m surprised on a daily basis by how many people aren’t ready, or at least making an attempt to GET ready. Don’t most people like to be sure of what diagnosis they are giving – or getting for that matter? And another issue which medical professionals typically don’t like to talk about is (whispering voice) money. Doesn’t everyone like to get paid? (shhhhhh…..)

Think about hanging a picture on a wall – all you need is a hammer and a nail, right?
Well, what happens if you don’t have a hammer? What if you have both – but the wall is concrete – will that nail work? What if you have both the hammer and the nail, but the picture is HUGE and weighs 142.5 lbs. Will you still accomplish what you originally set out to do?

hammerIn that scenario, without a hammer you would find one or use something else. (I’ve used a meat tenderizer before and it actually works quite well!) If you don’t think the type of nail matters, go to a hardware store or even your local drugstore and check out the variety of nails available today. Guys should get this – and they are probably laughing right now… Whatev!

Anyway – you get the idea. What you ultimately decide as your “tools” to convert ICD-9 to ICD-10 determines how the job will be done. It might actually work (bricks make great hammers too) but was it done right?  In a sense, that’s kind of what the new ICD-10 coding is like.

In ICD-9, there were too many codes which were not specific enough or didn’t even exist. There are so many more codes to choose from in ICD-10 and that requires doctors to really specify to their coders/billers what the diagnosis is so the right code is used on the claim. But don’t think that’s enough – the documentation MUST support what you did as well. Kind of always did have to be included in the notes, but I digress…

Ask questions and learn about it NOW! Doctors should start conversations with their staff about anatomy and any medical terms they think staff might not be familiar with. Talking about your specialty and what you are actually thinking and doing to come up with the care you give patients is interesting – some of us really look up to you!

What have you done to prepare? If nothing, are you looking into consultants and certified coders to help you in November and December when the insurance checks have stopped coming in?


About Heidi Kollmorgen

My passion and interest involves anything related to medical billing, coding and health information management. I love to share what I learn and educate others so you have definitely come to the right place! ICD-10-CM is set to become mandatory beginning October 1, 2015. As an AHIMA ICD-10-CM Trainer also carrying the title of CCS-P (Certified Coding Specialist - Physician Based) you can be assured that quality care of your patients is the ultimate goal of my work as a consultant. HD Medical Solutions is dedicated to providing you with all your Revenue Cycle Management needs.
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