Start the ICD 10 Training for Anesthesia



Start working on your documentation now. Look at what codes your practice uses most frequently. And if you're having problems with them now, you're going to have more problems with them when you get to ICD-10 because ICD-10 is a very specific medical coding convention.


The details that we're going to be getting to are so minute and fine that we have to now start looking at what is our practice doing that they can do better. And by the time ICD-10 comes around in 2014, hopefully you all have already ironed out all of the practice problems that you are having.


To do that, you're going to have to perform an internal mini audit to just look at whether the documentation you have matches the codes that are being reported. And if you have more than one coder in your practice, it's a good idea to have someone else other than the person who coded it do the mini audit because it's hard for a coder to catch their own mistakes particularly if they're tied to knowledge and not, you know, just the transposition of numbers.

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Now, if you're not in a practice where you have more than one coder, try to kind of rope in one of your physicians to see if they can help you, if you're not a coder or a certified coder, do a mini healthcare audit. Because certainly, your physicians are qualified to tell you whether the documentation they have on file matches the code description in the book.


Communicate the Details

They're going to be specific to you but fractures was a huge one in your practice. Often it is because you wouldn't get the specific bone. It might just say hip fracture or leg fracture and that puts the coder at a distinct disadvantage because you don't know specifics. You don't know whether it's open or closed but we do have medical coding rules that tell us we have to code it closed unless it's specified it's open. But we need other details to get us to that correct diagnosis code such as distal.


For instance, arthroscopies and arthroplasties, both diagnosis and procedure-wise because for procedure, you're going to lose a unit if you don't have the right documentation. For the cataracts, we need senile or nuclear to try to get us out of that unlisted code of 366.9.


So similar to this list, you can create your own that says, “Here is our problem.” And if you have a chief CRNA or a chief anesthesiologist or a medical compliance officer or just someone in your practice that is, you know, someone that the rest of the clinicians will listen to, get their help to get your diagnosis information in a better place before 2014. You want to have all of this background already taken care of before you get to the ICD-10.


Under ICD-10, your codes are going to be much more specific. We're going to go from a limited set of codes to a large increase. Office training is going to be required with everyone. if you go ahead and have started your training or do start your training, that's a good thing.


CPC coders as well as AHIMA are required to retest. If you're not ready for 5010, you're going to have to be. Don't wait for vendor communication. If they haven't contacted you, contact them. You cannot wait until the last minute, like October, and expect them to have 5010 in place for you by January of 2012.


ICD-10 is going to involve a lot more specific information and clinical information and it's to help measure these healthcare services on par with the rest of the world. Right now we have different databases of information between ICD-9 and ICD-10 that will be able to be combined once everyone is on the same books.


Hopefully, it will decrease the need to include supporting documentation with claims because of the extra specificity. But you're going to need to start working with your clinical practitioners now to determine what the extra coding and compliance information is you're going to need.


The code assignments for the new ICD-10 are going to follow some similarities with ICD-9 and that the chapters divide them out. Ffor example, that K will mean Chapter 11. Any of your codes that start with K are coming from the diseases of digestive system, Chapter 11.


Hernia falls under 40 to 46 so ventral is defined as 43. And then .90 is probably going to be substandard throughout the rest of the book and that it will be without obstructions, gangrene or unspecified. So you may see that .90 as an unspecified in other areas as well.


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