Educating the Enterprise on ICD-10

On the list of exciting topics for enterprise-wide motivational meetings, ICD-10 is unlikely to rise to the top.  Starting off your Monday morning with an overview of 79,500 ICD-10-CM and 72,100 ICD-10 PCS codes can be about as exciting as watching grass grow.

Given the impact of ICD-10 on the revenue cycle, quality measurement, and risk adjustment, it's clear that we must educate all stakeholders about the importance of the initiative, the workflow challenges we'll face, and the need to improve our existing documentation.

We kicked off the BIDMC enterprise communication plan in January 2013 and in February, I presented this overview to all directors, managers, and supervisors.

They key take home messages were:

  • ICD10 requires that we code and bill differently than we do today
  • ICD10 is an FY13 Annual Operating Plan Goal
  • The majority of BIDMC revenue is at risk
  • Implementation and training will involve every department at BIDMC
  • We must be fully live by October 1, 2014

I used several examples to build a lasting impression of ICD-10 such as:

If I go climbing in New Hampshire and crush my wedding ring finger in a rock, my ICD-9 code would be 915.8 "Other and unspecified superficial injury of fingers without mention of infection". My ICD-10 code would be S60.445A "External constriction of left ring finger, initial encounter." Since injury cause and location are coded separately, it is certainly possible to be struck by a turtle (W5922XA) in a squash court (Y92.311).

There are initial encounters, subsequent encounters, and sequelae. Important codes to know are:

Bitten by Orca, initial encounter (W56.21XA)

Sucked into jet engine, subsequent encounter (V97.33XD)

and the Hitchcock classic - Bitten by birds, sequelae (W61.91XS)

All recognized the incredible training effort required to get clinicians and coders to apply ICD-10 properly.  More daunting is the need to improve clinical documentation so that it can justify the high degree of granularity possible with ICD-10

As we develop further training materials, posters, and broadcast communications, I'll share them on the blog.