Medical Billing Forum

Coding => Coding => Topic started by: Angie on August 03, 2015, 09:25:42 AM

Title: ICD-10
Post by: Angie on August 03, 2015, 09:25:42 AM
I had a question about the ICD 10 coding.
We have the new code set. Our therapist currently are using the DSM 5 (ICD 9) on the patient charts.
The therapist/provider will need to start putting the ICD 10 code on the chart 10/1/15 correct; this is not just for insurance billing purposes? It has to be on their charts?
Title: Re: ICD-10
Post by: RichardP on August 04, 2015, 02:57:26 PM
None of our providers puts codes "on their charts".  They put words.  Insurance carriers won't accept words; they need the ICD codes.  But - the codes sent for payment must be supported by the words in the chart.
Title: Re: ICD-10
Post by: PMRNC on August 05, 2015, 02:43:25 PM
I never allowed my mental health clients to use DSM which has been a good thing over the years, less of a transition to ICD-10. My clients with the exception of ONE who has a CPC on staff are ready, they are required to give codes as I'm not a coder. Anything I receive without a code goes back to them. There are and have been many different ICD-10 courses over the last few years that physicians/providers should not have a  problem like many are thinking they will. They have an advantage over any coder as they are in the room with the patient. My providers all know the importance of good coding and documentation. All my encounters come in to me coded.
Title: Re: ICD-10
Post by: RichardP on August 06, 2015, 01:17:21 AM
Linda - your experience is similar to mine.  We receive fee slips / superbills with the codes on them.  If the original poster meant fee slips / superbills then my response was inappropriate.  Her use of the word chart led me to think she was refering to the documentation of the encounter that physicians must do, not the fee slip / superbill.
Title: Re: ICD-10
Post by: Angie on August 10, 2015, 09:30:39 AM
Thanks for your response.
This one is for a facility that I am employed through and the therapists do not think they need to put codes on the Discharge Summary; which is where they are now putting the ICD 9 codes on that we use to create the super bill with. They are stating I can just convert them but I am not a coder. I have the new book to convert them but feel the documentation should match what we are putting on the super bill......
Am I correct here or am I missing something?
Title: Re: ICD-10
Post by: RichardP on August 10, 2015, 05:08:09 PM
The codes you use to bill with must be supported by what is written (words, not codes) in the chart.  Many of the ICD-9 codes convert directly to ICD-10 codes.  If the therapist has picked the correct ICD-9 code, there would not be any problem with simply substituting the ICD-10 code in those instances where there is a direct conversion.

The problem comes when a single ICD-9 code is broken out into, say, 3 different ICD-10 codes.  Without knowing what the words in the chart say, how do you know which of the three choices is supported by what is written in the chart?  In that situation, it is extremely irresponsible for the provider / therapist to say "oh, just pick one; any one of the three will do".

In our situation, in most instances, our providers only mean one thing out of many possible things when they choose an ICD-9 code.  So we would have a pretty good idea about which of the three ICD-10 codes we should substitute for the ICD-9 code (to continue the example given above).  Even with that, we aren't going to do it.  We are asking our providers to choose which ICD-10 to substitute for the traditional ICD-9s they have used over the years.  When they have finished choosing, we will substitute all of the chosen ICD-10 codes for the ICD-9 codes they are replacing.  They will still choose a code by the definition attached to it (we aren't changing that).  It's just that the code at the end of the definition will be ICD-10, not ICD-9.
Title: Re: ICD-10
Post by: Angie on August 11, 2015, 09:50:44 AM
That is what I thought and thank you very much for clarifying this!
Title: Re: ICD-10
Post by: PMRNC on August 11, 2015, 10:06:20 AM
I would just like to add that you want to try and get your clients away from the DSM. The DSM-5 actually only has HALF of the codes needed for transition to ICD-10!!   If you get your clients used to their ICD-10 NOW, it will help tremendously. There are so many resources for clinicians and therapists to have been learning ICD-10 that they really cannot use that as an excuse. If they refuse, then they need to bite the bullet and hire a CPC proficient in ICD-10. The billers should NOT take on the responsibility of coding.
Title: Re: ICD-10
Post by: Angie on August 11, 2015, 01:05:34 PM
Agreed Linda! They are giving me such push back on this; I have one therapist that does not even believe me about the whole ICD-10; even with all of the resources I sent to him, he said none of it is true! I am just not going to put codes on anything that they do not provide me a code with; Guess if they dont I will be unemployed and looking for another job!
Also I read an article that said the DSM are not HIPPA compliant? Have you heard that at all?
Title: Re: ICD-10
Post by: PMRNC on August 11, 2015, 01:19:11 PM
No DSM is NOT compliant.. I made all my clients get rid of DSM YEARS ago .. so I'm not running into a problem now.
Title: Re: ICD-10
Post by: rofakamrd on August 11, 2015, 01:48:05 PM
just a side note on dsm vs icd... in the past dsm mirrored icd.... that will no longer be the case.... for my doc's i have provided a cheat sheet with the conversions. i included both icd-9 to icd10 along w/descriptions!... so they will be providing the dx... ... this is a web site given to me by someone at uh...  that maybe helpful for others..
Title: Re: ICD-10
Post by: RichardP on August 11, 2015, 04:16:57 PM
ICD-10 Code Set
ICD-9 Code Set
Converter - Convert either direction