3 Tips for Adjusting to ICD-10

ICD-10 is here – the new comprehensive coding system for everything that could possibly affect your health and wellbeing, including those pernicious squirrel bites. This is not a guide to the ins and outs of ICD-10; this information is quite capably covered by the inimitable Every ICD-10 Twitter account that regularly plumbs the depths of human ill health, as uncovered by the classification system.

Instead, here are three practical tips to help you and your practice transition to the coding system. All of these are common sense and simple and cost-effective to implement, yet often forgotten in the rush to get everything just right.

Tip 1: Focus on those codes that cover your practice

A radiologist won’t be looking at squirrel bites. A dermatologist or General Practitioner might be asked to repair the damage done by the squirrel, and an infectious diseases specialist might be interested in the health of a squirrel that bites humans. But even though those practitioners could potentially see a squirrel bite in their practice, how often do they see them? Rarely.
General practitioners, for example, are far more likely to see coughs, colds, or mental health problems.

There are two ways of determining which codes are most relevant to your practice – the first is to audit your own documentation, and the second is to poll the doctors and nurses who work there. While audits provide objective data, their quality crucially depend on the diligence with which practitioners have been coding their consultations. Subjective opinions are very good at identifying your practice’s bread and butter.

Tip 2: Focus on incentivised codes

Different health care systems vary in the incentives they have for getting practitioners to use appropriate codes. The US health care insurance system has a whole billing infrastructure system that is geared to punish the unwary coder, while in the UK, General Practitioners have the Quality and Outcomes Framework, which focuses on common chronic diseases and key services, such as maternal and child health.

Getting those incentivised codes right will provide the biggest immediate pay-off. So, once you have made an inventory of the codes that cover most of your practice, you can drill down further by separating out the incentivised ones.

Tip 3: Focus on your single most important coding problem

This is where you need to be able to critically analyse your own failures – areas that go underreported, bills for codes that are constantly returned by insurers. Instead of instigating sweeping reforms or revising your processes from the ground up, it is easier and faster to pick out the one code that is costing you the most in late payments, the one indicator that is most consistently underreported, and fix this coding problem only.

This approach has several advantages:

  • It overcomes paralysis by analysis by giving you a clear focus
  • It maximizes the payoff and minimises the initial investment of time and effort
  • Finding and fixing one large problem will shed light on what might need to be done to fix smaller, related problems

What are your main coding problems? How are you tackling ICD-10 in your own practice?

Are you interested personalized consultation to make your own electronic health record system work for you? Then contact me – I also offer 24-hour turn around Quick Clinics for fast, useful feedback on nagging problems.