ICD-10 Physician Update

Question:  ICD-10 compliance is mandated to occur on October 1, 2015, which is only a few months away. With the switch from ICD-9 to ICD-10 rapidly approaching, how will ICD-10 impact physicians and providers and what is HCA doing to prepare medical staff in our hospitals?

Answer:  Physicians will see impacts from ICD-10 in the hospital environment in two primary ways: Changes to their electronic documentation workflow to support more precise documentation, and Changes to the existing coding queries.

Documentation Specificity Physician Impact

  • The shift to ICD-10 will require a high degree of specificity in medical record documentation to support ICD-10 coding, which in turn will be used for quality reporting, reimbursement, and research much the same as today.
  • ICD-10 codes will support more precise quality measures and analytics and will provide a more accurate picture of a patient’s disease progression and treatment outcomes.

Coding Queries Physician Impact

  • Query updates for ICD-10 are in final reviews now and will be published during July to September of this year.
  • At the start of ICD-10, the number of coding queries will likely increase as physicians and coders become more comfortable with changes, but the greater degree of specificity provided by ICD-10 will provide opportunities to reduce the number of coding queries over time.

The ICD-10 Provider Documentation Readiness Team has established two work streams for this effort: Work Stream 1: Physician and Provider Education, where the bulk of focus has been to date, and Work Stream 2: ICD-10 EHR Integration, where EHR enhancements will support documentation in the provider’s workflow. In addition, the REGS department is leading the effort of revising and publishing updated and new coding query templates.

Work Stream 1: Physician and Provider Education

The first work stream focuses on three buckets of ICD-10 related education that is available for physicians and providers:

  1. ICD-10 Documentation Education:

The purpose of this training is to provide the essential knowledge related to supporting accurate and compliant ICD-10 documentation. Provider documentation education is available online and includes a series of modules that address:

  • ICD-10 core concepts,
  • overview of the standardized terminology of ICD-10-CM, common documentation errors, and new terms and concepts,
  • overview of documentation requirements for ICD-10-CM, along with reviewing highly impacted diagnoses, diseases, and conditions,
  • overview of documentation requirements for ICD-10-PCS, covering new concepts like device, approach, and root operation, and
  • a selection of 50 specialty-specific courses that provide an overview of documentation requirements and common diseases/disorders in the specialty

This education is now active in HealthStream – and is auto-assigned to all users in the Physician Learning Center. Instructions for accessing the education are included here: Physician Learning Center Access.

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