Cardiovascular Business - November/December 2008 - (Page 34)

Time to Train for New ICD-10 Codes News & Views á New ICD-10 codes help specificity, but at what expense? seven alphanumeric characters, the maximum with the new ICD-10 codes, compared with a maximum of five with the old codes. The deadline to transition to using the ICD-10 codes is Oct. 1, 2011. Many people say these deadlines cannot be met. Representatives of the Medical Group Management Association (MGMA), the American Medical Association (AMA) and America’s Health Insurance Plans (AHIP) are advocating deadlines of 2011 and 2014, respectively, for the changeovers. Others say the wait has been long enough and want to make the transition sooner than later. The ICD-10 codes have actually been in effect in other countries for nearly 10 years. The U.S. is the only industrialized nation that has not yet implemented them. Biga remains unconvinced as to the benefit of adding more codes. For example, cardiology currently has four codes for hypertension in ICD-9; with ICD-10, there are eight. “If I have heart failure, how deep does one need to code high blood pressure and how much detail is needed to accurately code a disease process? Will using ICD-10 codes affect patient care or improve outcomes as opposed to ICD-9?” she asks. The new cardiovascular sec- Other, 4.1% 25-32 hours 11.7% 17-24 hours 16 hours or less 24.1% 60.0% W hether the threeyear conversion proposed by the government for the new ICD-10-CM codes is realistic or not remains to be seen. What is evident, however, is that the transition from the old set of codes to the new ones will cost money. “Overall it’s going to have a huge financial impact across the board and cardiology will probably be no more or less hit than anyone else,” says Cathleen Biga, president and CEO of Cardiovascular Management of Illinois. “The cost will be extreme, not only in changing all of our systems, but in changing the software, hardware and the educational component for both physicians and staff.” The ICD-10-CM/PCS code set, with more than 155,000 codes, will replace the 30-yearold ICD-9-CM code set, which has about 17,000 codes. The increased number of codes adds an improved measure of specificity, which, in turn, should lead to better reimbursement and outcomes data. There are two deadlines set by the government. First, facilities have to update to what’s known as the “Version 5010 of the X12 transaction standard” by April 1, 2010. This tweak allows each coding system to accommodate in 2003, the american health information management association (ahima) tested 169 volunteers using the iCD-10-Cm. respondents were asked how many hours of training they thought they would need prior to implementation. the majority (60 percent) indicated that they would need 16 hours or less. Source: ahima tion has not seen major changes from the old. Some of the changes are: codes for complications following an acute MI and codes for subsequent MIs. Arteriosclerosis of bypass grafts of the extremities have unique codes for manifestations such as gangrene, ulceration (even by site of ulceration), claudication and rest pain. “Having more codes does not necessarily equate to increased complexity; in fact the opposite is true,” says Ann Zeisset, RHIT, CCS, CCS-P, manager of professional practice resources at the American Health Information Management Association (AHIMA). “It is actually harder to figure out where to classify something when there is no code for the condition, than when there is a code available.” In preparing for the change, practices should communicate early and often with vendors. They need to also conduct an impact assessment, which includes creating an implementation planning team; identifying and budgeting for required information system changes; and assessing, budgeting and implementing clinician and code set user education. Next, they should gear up for overall implementation, by following through with required information system changes, conducting a followup assessment of documentation practices and increasing the education of their coding professionals. In preparation for go-live, practices should then finalize system changes, test claims transaction with payors; continue with intensive coding education; monitor the coding accuracy and reimbursement with prospective payment systems results and other reimbursement systems. Af ter go-live, it is imperative to monitor coding accuracy for the new code set’s impact on reimbursement and data management, as well as monitor productivity and to continue with appropriate coding training. BY Sarah L amBerti 34 Cardiovascular Business November/December 2008

Table of Contents Feed for the Digital Edition of Cardiovascular Business - November/December 2008

Cardiovascular Business - November/December 2008 Contents First Word Cover Story: Practice Management Software Moves Beyond Bean Counting The Death of CME as We Know It? Clinical Study Digets: Triple-Antiplatelet Therapy; Ex-Vioxx Users Beware Shockwaves Subside from the FDA's Echo Contract Warning Burning Question: Does Laser Heart Therapy for Angina Really Work? Advanced Visualization Adds New Practive Dimension Coronary Calcium Scoring Program Reaps Dividends Interventionalists Get Pumped Up About Mechanical Chest Compression Trials Force Physicians to Re-Examine Oral Anti-Diabetic Drug Protocols News & Views Calendar Reader Resources The ACC Corner

Cardiovascular Business - November/December 2008

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