5 days… 5 reasons to be afraid of ICD-10

  1. Revenue, Revenue, Revenue- of course we all know that physicians and clinicians, nurses and physician assistants all LOVE the art of medicine. But would you love it as much if you didn’t get paid to practice it? Could you practice for less revenue than what you are earning today? And, if so, how much less? At what point would you call it quits and simply switch professions?  If you aren’t ready to work with the new ICD-10 codes, you’re going to lose revenue. You’d better educate yourself, or have a backup plan in place to earn less than what you are earning today.
  2. Plan_B_600Speaking of Backup Plans- Is your technology ready for ICD-10? Moving from a maximum five-digit code to a maximum seven-digit code is going to require your practice to have new hardware and software to handle the changes.  A change that can’t wipe out your patient history being stored in three to five-digit diagnosis codes.  It’s like the famed Y2K bug that never materialized, but this one will for many in the medical field.
  3. Electronic Health Records- Until you get used to the documentation requirements for ICD-10 you are going to have to actually use the notes you have been making for the last 10 or maybe even 20 years for your long term patients. Status post MI isn’t going to cut it anymore. You are going to need the actual date of that MI treatment.  No kidding.
  4. New Guidelines- Yes you will no longer be able to document how many weeks pregnant your patient is- you are going to have to document the trimester. The first trimester being 0 to 14 weeks (to the day). The second trimester now begins 14 weeks, 0 days through 27 weeks and 6 days. The third trimester begins on day one of 28 weeks through delivery. Bigger documentation changes in Orthopedics too beginning with requirements in documentation for right or left or bilateral and identifying specifying the care encounter- first encounter, follow up or sequela.
  5. Query’s – What? Where? Why? As a clinician you are used to medical record coders, office billers or CDI specialists asking for more information. With the launch of ICD-10 the way you can be queried changes too.

Verbal and written queries CANNOT:

  • Lead the provider to a particular response,
  • Mention the financial impact of the query,
  • Imply gain for the physician or facility,
  • Ask the provider to document something that’s not clinical appropriate or accurate, or
  • Question the provider’s clinical judgment, but rather clarify inconsistencies, imprecision, or illegibility in the medical record.

Each written query must include:

  • Background information requiring clarification,
  • Risk factors, clinical indicators, and treatment(s) to support the query,
    • Medications,
    • Diagnostic test findings,
    • Other resources: nursing care, ancillary services, physician consultations,
  • Multiple choice options for diagnosis,
    • Options of “other” with blank and “unable to clinically determine”,

Are you ready?

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