August 10, 2011

Evaluating Technology to Attack ICD-10 from a Coding Perspective: Paper Versus Electronic

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The ICD-10 countdown continues, as all certified coders are facing the task of familiarizing themselves with the new coding system.

With Oct. 1, 2013 on the horizon, many will be preparing to take ICD-10 certification exams as part of certain coding association requirements. Paper and electronic methods are the two paths coders face as they begin to think about an attack on ICD-10 – so which path should you choose?

The use of the word “attack” is widespread, as every U.S. organization is faced with transitioning from roughly 60,000 codes in ICD-9 to more than 150,000 in ICD-10. The numbers are overwhelming; so overwhelming, in fact, that many seasoned coders have stated that they will retire before ICD-10 is implemented. Being that many coders are visual thinkers, many believe that paper is the only option, specifically since those sitting down to take the ICD-10 certification exam will need to use a paper ICD-10 code book.

Whether you are a coder, a HIM director with coding staff or part of an ICD-10 risk assessment committee, do you know how you, your team and/or your organization are going to attack learning the ICD-10-CM and PCS coding systems? Many may default to paper code books, but if you think about coding from a workflow perspective, it makes the most sense to take advantage of modern technology. Still, there is no need to choose one or the other. You can pair them together as a single plan of attack and look for electronic tools that can assist coders in learning how to use the required paper code book.

Considering Workflow Tools

From a broader perspective, aside from the paper code book option, other types of ICD-10 workflow tools to consider obtaining include any that will assist in learning the actual code sets, assist in current workflow activity to translate codes from I-9 to I-10 and assist in learning ICD-10 from a regulatory standpoint. These tools possibly could include a subscription to electronic educational courseware, specifically sources with a strong focus in anatomy and physiology.

There are options out there in the marketplace, and many organizations already have multiple tools that may help them accomplish some of these objectives. Also, take a moment to assess the coding workflow. You soon will realize how your organization easily can limit coder apprehension about learning the new coding system, increase coder longevity and productivity and save money at the end of the day if you choose coding workflow tools wisely.

Workflow coding tools should provide the following in one easy-to-use format:

Coding – Ensure that electronic code books are available and contain both ICD-10-CM and PCS. The CM electronic code book should be comprehensive, featuring guidelines and indexes, and the PCS e-code book should include guidelines, indexes and a reference manual. The electronic code books should be paired with some type of ICD-9-to-ICD-10 translation tool. This tool should assist the coder in analyzing current code sets under ICD-9 in comparison to those in ICD-10.

Regulatory Resources – Correct coding is driven by regulatory information. Providing access to CMS notifications and regulatory issuances such as The Federal Register and CFR will be key to a coder’s success. Additionally, a quality coding workflow tool should have the capability to highlight and anticipate the addition of local and national coverage determinations as well as updates to the ICD-10 coding system in the form of CMS manuals and transmittals. Be prepared, as payers and CMS soon will provide direction for accurate claims submission as we continue to move forward towards ICD-10.

Education - Electronic educational courses paired with coding and regulatory information can be very powerful in helping the coder tie it all together. Courses should include not only a comprehensive overview of the ICD-10 coding system but also components related to anatomy and physiology, clinical implications, and medical terminology: items to help coders adjust to the specificity required by coding with ICD-10.

 


 

The Role of Technology

Evaluating technology used to facilitate learning of ICD-10 code sets is not an easy task, yet the technology should be able to do the following from a coding workflow perspective:

I. Offer an electronic translation tool that allows the user to perform a simultaneous keyword search of ICD-9 and ICD-10 for direct comparison (and not just by code searching).

II. Provide transparent access to the General Equivalent Mappings (GEMs) and reimbursement maps so that the search results are obvious and direct, including forward and backward mapping.*

*Many have argued that coders should not use GEMs to code or even have access to the reimbursement maps. The GEMs and reimbursement maps should serve solely as a guide for coders, and should not be seen as a replacement to actually learning the new coding system.

III. Provide understanding of the implications of ICD-10 on MS-DRGs via an interactive MS-DRG grouper.

IV. Present current and archived guidance to assist coders in understanding how ICD-10 impacts other coding areas such as claims processing, Medicare benefit policy rules and national and local coverage determinations.

V. Include free training and support; this is an unfunded mandate from the government. Although development is an incurred cost by vendors for these workflow tools, institutions should not be burdened with software installation and training costs.

Choose to be a leader in learning ICD-10, and pair paper code books with electronic tools to facilitate the transition. The use of electronic coding workflow tools not only will improve efficiencies and lower administrative costs, but also reduce coding errors and claim rejections. It will lead to achieving an organizational enterprise goal to be in compliance and submit clean claims correctly the first time.

About the Author

Maria T. Bounos, RN, MPM, CPC-H, is the Business Development Manager for Regulatory and Reimbursement software solutions for Wolters Kluwer.  Maria began her career at Wolters Kluwer as a product manager, responsible for product development, maintenance, enhancements and business development and now solely focuses on business development.  She has more than twenty years of experience in healthcare including nursing, coding, healthcare consulting, and software solutions.

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Read 80 times Updated on September 23, 2013
Maria Bounos, RN, MPH, CPC-H

Maria T. Bounos, RN, MPM, CPC-H, is the practice lead for coding and reimbursement software solutions for Wolters Kluwer.  Maria began her career at Wolters Kluwer as a product manager, responsible for product development, maintenance, enhancements and business development and now solely focuses on business development.  She has more than twenty years of experience in healthcare including nursing, coding, healthcare consulting, and software solutions.