Despite ICD-10 Delay, Begin Compliance Journey Now

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

Home Health Agencies ICD-10 Implementation DelaysAlthough the implementation of ICD-10 code sets may be delayed, now is not the time for complacency, say speakers during the McKesson Homecare and Hospice 2012 National Users’ Conference.

“This is your lifeboat,” McKesson regulatory advisor Terry Miller says of the delay. “The more proficient you are at ICD-9 coding, the better you’ll be at ICD-10 coding.” The current coding system is more than 30 years old, and the United States is the only industrialized country not to have made the switch. There are two incarnations of the new code sets – ICD-10 CM for diagnosis coding and ICD-10 PCS for inpatient procedure coding.

ICD-10 CM offers:

  • Lower costs through increased efficiencies
  • Synergistic effects with the Electronic Health Record (EHR)
  • Clearer recognition of medical advances
  • Clearer recognition of technological advances

Proper training and plenty of practice will be vital because ICD-10 includes 68,000 disease codes and 87,000 procedure codes. A new alphanumeric system has specific coding for initial and subsequent encounters and the ability to differentiate between the left and right parts of the body. This specificity will help enable emerging care models with an increased ability to measure healthcare quality, safety and efficiency.

Release 12.3 of Horizon HomecareTM and Horizon Hospice TM will include the ability to code diagnoses in both code sets so billing staff can gain valuable experience to smooth the eventual transition to ICD-10, says Cheryl Apfel Wise, specialist business analyst for McKesson.

In addition to dual coding enabled by home health software, your back-office staff should begin to audit the diagnosis coding, asking these questions:

  • Was the primary diagnosis correct?
  • Was the primary diagnosis supported by the clinical documentation?
  • Were there “fatal errors” in coding selection?
  • Does the coding process facilitate timely billing?
  • Was the clinician’s approval of coding documented in the record?

The changeover also will likely impact the overall management of your agency. A question on a recent McKesson client survey to homecare agencies addressed whether agencies employ a centralized approach to coding. Three in four respondents said that they did. A related question was whether that approach would change after the transition to ICD-10. While sixty percent said it wouldn’t, one-third of respondents said they still weren’t sure how ICD-10 would impact how they coded.

The time to begin answering these questions is now, Miller and Wise conclude. The following links will take you to specific sites where you can find valuable resources to help you on your journey to ICD-10: CMS, World Health Organization, American Health Information Management Association.

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