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ICD-10 - Will it really affect you?

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HeidiK:
I'm happy to see interest in this subject - it's only 6 months away so anything you can do is a step in the right direction!

In regards to the ICD-10 training tool on the World Health Organization (WHO) website, it should be understood that this is information pertaining to ICD-10, which is different.  ICD-10 was adopted by the World Health Assembly in 1990 and has been used by many countries, including the U.S., for mortality reporting (coding of death certificates).

ICD-10-CM-PCS is the Clinical Modification set which will be used on October 1, 2014 and the guidelines and use are quite different.  It may seem confusing, although the history and development of the coding set are available online for anyone interested.

Michele:
Thanks for pointing out that the crosswalks are NOT 1 to 1 matches.  There are just a few ICD9's that can be directly matched to ICD10's.  Most must be manually matched based on additional info.  The crosswalks are a great tool to point us in the right direction but they cannot be used exclusively to replace old codes.

HeidiK:
Here is another article with additional reasons ICD-10 translation tools should be questioned...

http://icd10watch.com/blog/why-you-should-resist-temptation-icd-10-translation-tools

RichardP:
Heidi - I was not questioning the correctness of the information in your post.  You mentioned guidelines, and links to those guidelines will be helpful for future readers who maybe don't know where to start.

I think the specialist is going to have a more complicated transition to ICD-10 than the generalist.  I extracted all of the codes our clients have actually used over the last 15 years (a good mixture of generalists and specialists).  After deleting duplicates, I am left with about 1600 unique codes that our clients have actually used in the last 15 years.  About 500 of the codes are used regularly.  The rest, sporadically.  Of the 500 used regularly, about half translate "directly" to a single, specific ICD-10 code.  Examination shows there is no other ICD-10 code that is more appropriate.  Another quarter of the 500 codes translate "approximately" to a single, specific ICD-10 code.  Examination shows that, for most of them, there is no other ICD-10 code that is more appropriate for how the doctors are using the ICD-9 code, even though the translator said only "approximately".  The last quarter of the 500 translate "approximately" to two or more (sometimes six or seven) ICD-10 codes.  A cursory examination shows that only one or two of the multiple codes offered are anywhere near relevant to how the doctors use the ICD-9 code.  And so - for most of our generalists, the translation to ICD-10 is going to be relatively straight-forward for the most-used codes.  I am assuming that the infrequently-used codes will require a closer examination, which I haven't done yet.  And, as Heidi demonstrated, the codes for the specialists require much more specificity, and therefore much more care in their selection.

Of course, the proof of all of this will be in whether the codes get paid or not after October 1, 2014.  I expect there will be some period of adjustment based on what codes don't get paid (if any).  I'm working to minimize the adjustment needed.

I am not a coder, and my selections will be provided to our clients for their final examination and approval.  I'm just simplifying the process for them.  I am using this translator:

http://www.icd10data.com/Convert
http://www.icd9data.com/2014/Volume1/default.htm

HeidiK:
Hi Richard!

Your obvious dedication to performing a valuable service for your clients is amazing!  The process you are taking is what it takes to be prepared for the October 1 deadline.  I'm sure you will agree, it was a bit time consuming, am I right?  :)

Once you are familiar with the guidelines, codes and process it will be a much better system to work with than ICD-9 for everyone.  And yes, specialists will have more challenges during the initial phase although preparing now will avoid any cash flow issues later this year.

Thank you for sharing your ideas on the process you are taking - I think it's amazing!

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