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Preparing health information management for transition to icd 10 3

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Preparing health information management for transition to icd

Preparing health information management for transition to icd

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  • 1. Preparing Health Information Management for Transition to ICD-10 In its current practice, health information management (HIM) in most medical institutions in the U.S. relies on the IDC-9 (International Classification of Diseases, Ninth Revision) for coding and reporting medical diagnoses and inpatient procedures. However, new developments in medical technology and knowledge have rendered IDC-9 inadequate in providing an accurate representation of current medical practices There are significant differences between ICD-9 and ICD-10. For instance, ICD-9-CM (Clinical Modification) diagnosis codes only number to over 14,000, while ICD-10 has a total of 68,000 codes. Additionally, the length of the characters in ICD-9-CM is 3 to 5 digits long, while ICD-10-CM is 3 to 7. The procedure code system (PCS) for both also differs. In ICD-9, the codes are 3 to 4 in length and numbers to about 4,000. In contrast, ICD-10-PCS is 7 characters long and numbers approximately 87,000. The increased number of codes and changes in the character length of each code reflects the need to increase code specificity and flexibility to accurately describe new technologies, treatment methods, and terminologies used today. The limitations of ICD-9 make it difficult for coders to select the most applicable code to document a disease, symptom, condition, circumstance, specific body part, and service provided. In consequence, payers may not be able to fairly reimburse claims for treatments patients have received. With ICD-10 set for implementation in the U.S., healthcare institutions must make adequate preparations for the transition to remain compliant with the new standard. Failure to make the change by the deadline can result in the rejection of the codes used in transactions for non-compliance. Making the transition, however, is not that simple. ICD-10 is more complex than ICD-9 due to the length and sheer number of the codes. Educating the staff on the structure and benefits of the new system would necessarily disrupt normal operations. Those who need retraining include the institution's HIM staff, accounting professionals, corporate compliance staff, auditors, and data quality management staff, among many others. The required hours for intense coding training are estimated based on the ICD-10-CM Field Testing Project of the American Hospital Association/American Health Information Management Association (AHA/AHIMA). Experienced coding professionals may require a maximum of 16 hours of training in ICD-10-CM, while physicians may need much less due to the fewer codes they may use. As for ICD-10-PCS, an estimated 16 to 24 hours additional training may be required. Participants in the study also believe that training should be provided 3 to 6 months prior to the implementation of ICD-10-CM. Internal testing is also necessary to ensure that transactions generated are compliant with ICD-10. An institution's clearinghouses, billing companies, and payers will also have to upgrade to ICD-10. External testing will then have to be performed to ensure that they are
  • 2. able to send and receive transactions using ICD-10 codes. Given the challenges of transitioning to ICD-10, healthcare organizations will require the assistance of a firm that specializes in health information managementparticularly in coding and auditing. Such firms can help medical institutions transition to the new system by providing resources that cover training, improve existing coding accuracy, and identify areas of improvement. In case institutions are short on HIM professionals who can supervise the upgrade, experts from these firms can serve as interim health information managers. In this position, they can identify staff that need training in ICD-10, oversee the operations and processes done during the transition, and ensure that Information Systems used by the institution are ready to accommodate changes. Woodham & Associates offer healthcare organizations services to help them prepare for ICD-10 adoption. To learn more medical coding company, visit Woodhamhim or call 1866-WOODHAM (966-3426).