Prepare now for ICD-10, says expert

Practice coding claims from ICD-9 to ICD-10
By Diana Manos
10:26 AM

If there was an overall theme at the HIMSS Media/Healthcare IT News ICD-10 Forum June 17, it was this: Don’t wait to get your house in order for ICD-10. Though the Oct. 1, 2014 deadline for the transition from ICD-9 to ICD-10 is more than a year away, most of that time will be required for getting ready, experts warn.

In an interview with Healthcare IT News, Farzad Mostashari, MD, national coordinator for health information technology, said his best advice for providers is to begin prepping for the change now.

Jill Wolf, VP of compliance for VitalWare, LLC, a speaker at the forum, echoed that – and advised health organization to try coding 200 claims into ICD-10 as a test, to see how easily they transfer from ICD-9 and what kind of documentation is needed to code for ICD-10. Then, take that information to the doctors to use in training them for ICD-10.

[See also: MGMA survey shows industry readiness for ICD-10 lagging.] 

“Don’t look at the top 10 DRGs [diagnosis-related groups] for your practice," said Wolf. "Most DRG shifts won’t be there." Look at DRGs that seem most unlikely to have a coding change from ICD-9 to ICD-10 from a predictive modeling point of view. Those are the ones that are most likely to see a 50 percent shift.

“Focusing on high volume DRGs won’t show you where shifts or opportunities will be,” she said. “You will still be forced to use a lot of NOS [not otherwise specified] coding, if you are missing documentation. You need to find those areas where documentation is weak and bring up to speed.”

Wolf said predictive modeling is cheaper than spending money and time to practice coding claims to ICD-10, but doing do may well be worth the extra expense.

“I want to emphasize that predictive modeling doesn’t always tell you what’s real,” she said.

[See also: MU audits off to a rocky start.]

Wolf also admonished providers to not only give coders the proper training for ICD-10, but coders should be urged to practice coding claims to ICD-10 starting now.

“They need to practice it and review charts and apply it," she said. "They need hands-on training. Don’t wait. I can’t encourage you enough to get them to do some [charts] every week."

After compiling an amount of data by coding claims from ICD-9 to ICD-10, analyze the results and group them into controllable and uncontrollable coding situations, Wolf says. Create a plan, implement it, and measure the impact against your goals.

Why should you do it now? Wolf said she thinks that doctors “really need a good database” of ICD-10 data for the education piece. Doctors respond better to training, when data is used. “They don’t want you to train them based on national averages," she said. "Show them their own data. They will be much more receptive to those results."

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