3 Considerations For ICD-10 In 2013

By Steve Sisko, Health IT/ICD-10 Consultant, shimcode.blogspot.com
Twitter: @ShimCode

ICD-10 has become a prime area of focus for healthcare providers. As plans are laid and budgets set, providers moving toward ICD-10 compliance should consider how a clinical documentation improvement (CDI) program, computer-assisted coding (CAC), and education/training can assist their organization with achieving not only ICD-10 compliance but also higher reimbursement and improving quality measures.

CDI Program
Providers who did not set up a CDI program when they implemented their EHR may want to consider doing so as they move toward implementing ICD-10. The specificity of ICD-10 increases the importance of strong documentation on both inpatient and outpatient sides. Complete, specific, and consistently documented information is needed to not only obtain proper reimbursement, but also serve as the basis for quality measurement programs and other statistical reporting. Providers will achieve the most benefit by focusing on documentation surrounding medical necessity and local coverage determinations associated with their specific focus and medical specialty.

CAC Tools
CAC automates manual documentation capture and/or coding processes whether performed by physician, clinical, and/or administrative staff. CAC options range from simple search and reference tools to rules-driven, speech-to-text translation engines. Some CAC applications purport to automate complex coding tasks by validating input against regulatory and payer reimbursement policies — doing away with much of the expensive work performed by coders. Look for a range of functionality offered across various access methods, including hosted and outsourced models. A key consideration is to understand vendor readiness and their product road map.

Education And Training
Educating and training your physician, clinical, and administrative staff are critical processes that must also be assessed, planned for, and begin in 2013. One benefit of the one-year delay is that thirdparty vendors and organizations have developed more mature education and training programs and options. Regardless of the number of people involved, whether the organization is a facility or professional practice, whether a CDI program exists, whether a CAC tool is to be used, and a whole host of other factors, a customized education and training plan will be required.