Updated on: September 23, 2013

Implementation Versus Code Set Training

Original story posted on: August 1, 2011

The transition to ICD-10 will be a large undertaking for every practice across the United States. The anticipation of the unknown has many people frightened and even considering retirement prior to the transition to the new and improved code set.

The new coding system is sure to bring many challenges and confusion. Today the confusion mostly seems to revolve around what a practice should be doing now to ensure successful and timely implementation of ICD-10. There are many options available on the market for ICD-10 training, and it is important to understand the differences in all the options that are currently available.

Understanding the type of training that will suit you and your practice best will depend greatly on your role within the practice and its size. People who are in charge of the implementation process require in-depth training now to guide them through the necessary steps required for preparation. This is not a task that can be handled within a few months; it will be a multi-year project that ends on Oct. 1, 2013.

Implementation training involves learning the steps that must be taken to prepare for the transition to ICD-10. It is the process of creating teams, forming committees and examining all areas of a practice or institution to gain insight into how ICD-10 will affect each. Planning for the implementation of ICD-10 should have started earlier this year. The very first step simply is having discussions about ICD-10 and raising awareness of physicians and senior-level management. There are still many providers who do not understand what ICD-10 is or why the transition is taking place at all. Discussions about implementing ICD-10 have been going on for more than 20 years, but it has been delayed repeatedly. CMS has indicated that the implementation date of Oct. 1, 2013 is firm, and there will be no delays.

While the process to shift to the new code set will be complicated, we must focus on the positives, which include the very reasons we are advancing to this new way of reporting diseases and illnesses. In order to take advantage of this new coding system and to use it to its fullest potential, we must have a solid understanding of how information is processed through it and why it is so important to collect accurate and very specific information. Plans to foster improvements in research, statistical tracking and understanding disease processes – not to mention a desire to shift to a coding system that currently is being used by every other country in the world – are some of the reasons behind the move to ICD-10. This transition will enable us to compare “apple to apples” with other countries and open the door for meaningful exchange of data through healthcare worldwide.

Implementation planning must come before code set training because the former planning process will take much longer than it takes to learn a new code set. There currently is a lot of anxiety among coders who want to learn the new code set now. While learning it early on would help alleviate the fear of the unknown, the problem is that if they become familiar with the new code set now and do not use it until 2013, they might forget the nuances of ICD-10. If they fall back to coding the way they are familiar with, we will miss the point of moving to a better coding system entirely. In addition, ICD-10 codes are still in draft form and subject to change, meaning coders choosing to spend money on code set training now  may risk spending money unnecessarily.

Coders can focus on anatomy and pathophysiology now. By gaining a clearer understanding of disease processes, it will be easier to assign codes in ICD-10, as the new code set includes a higher level of specificity. A very important aspect of a coder’s job will be to make sure that they are able to educate physicians and providers on the necessary components of the new code descriptions. Prior to obtaining training on the new code set, ensuring understanding or taking a refresher on A&P will help coders understand certain things about how a disease manifests itself or other systems that may be affected by a current disease. This information may assist coders in understanding and explaining to others why things are coded the way they are in ICD-10.

Coders who are not responsible for implementation should not begin learning code sets until the middle of 2012 at the earliest. This way they can learn it in time to reduce anxiety and begin using the code set immediately to assist in the education of providers. The best approach is to allow physicians to make gradual changes to their documentation now so they will understand the items that will be necessary in their documentation once the new code set is implemented.

ICD-10 will take strategic planning. No matter what your role, there are things you should be doing now to begin to prepare – whether it be implementation training or brushing up on A&P.

About the Author

Kim Reid brings over 22 years of progressive coding experience in health care to her role as Director, ICD-10 Development and Training for AAPC. She has a vast range of knowledge from working in a variety of professional medical settings, including a large academic medical group in Vermont with 500+ physicians. Her most recent role as a Senior Coding Educator proved her success in leading physicians and students to achieve comprehensive levels of understanding on complex coding and documentation guidelines. She is a national speaker who presents regularly on various coding topics across the country.

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