ICD-10 Challenges to Overcome
What is it about the ICD-10 implementation that is such a challenge? One large hurdle is documentation. ICD-10 requires meticulous, specific documentation that most clinicians simply aren’t accustomed to. And, as with all behavior changes, it takes time to make adjustments. Physicians will need to begin as soon as possible to utilize the level of specificity that ICD-10 will require, or risk serious billing problems post-implementation. Without proper documentation, revenues will suffer.
And beyond billing, it’s important to remember that ultimately, improved documentation leads to improved patient care.
For hospitals, there is an additional layer of documentation complexity, because in addition to ICD-10 CM, they need to be prepared for ICD-10 PCS (procedural coding system). This complex set of tables requires detailed reports in order to build the correct code, including body part and system, procedural approach and device, and other modifiers that must be correctly documented for successful billing.
It’s important for providers in all settings to adjust their documentation practices now to reduce problems upon implementation.
Closely related to documentation challenges is the need for improved tools such as computer-assisted coding, advanced EMR systems and SNOMED, to facilitate the transition to updated billing practices.
Another issue is the technology itself. ICD-10 will require significant system upgrades for many practices. The first step is simply ascertaining which systems require upgrading or replacement.
And as the specificity of ICD-10 comes into play when mapping ICD-9 codes to ICD-10, that presents additional difficulties. If your IT staff members are unfamiliar with ICD-10, they may end up mapping unspecified ICD-9 codes to unspecified ICD-10 codes.
This may seem harmless, but it carries the very real risk of an audit if those codes are submitted.
Finally, one of the most serious considerations in ICD-10 implementation is the security of sensitive information. As you upgrade your systems and integrate new components, you will need to meet HIPAA requirements. Be sure you test your systems thoroughly to ensure compliance, and to keep data safe from theft.