AHIMA: Watch for 'challenges' in transitioning EHRs to ICD-10

The delay in implementing ICD-10 may give providers some breathing room, but they still need to address the challenges of changing their electronic health records to handle the upgraded coding, according to Michael Stearns, a member of the American Health Information Management Association's Clinical Terminology and Classification Council.

In an article in Physicians Practice, reprinted with permission from AHIMA, Stearns notes that EHRs were built around the "business logic of medicine" to capture codes for proper claims submission. However, the methods used by EHR systems to do so vary widely. For example, he says, there are some codes in SNOMED that are a boon for research or clinical work but that don't directly translate to ICD-10, or even ICD-9 codes.  

Another problem area, according to Stearns, is that some of the EHR templates have been embedded with ICD-9 codes. Those templates will need to be updated to ICD-10, which can be complicated by the fact that ICD-10 may require several codes when ICD-9 only needed one code.

"If a true central terminology model is in place, and no local modifications are needed to your clinical content, you may be in relatively good shape," Stearns writes. "If your EHR vendor requires that you update the codes and supporting documentation in your locally developed or modified clinical content, you have a few extra months to complete the task and to learn about the nuances of ICD-10."

Appropriate billing and claims submission has taken on greater significance in recent months amid concerns that EHR functionalities, such as copy and paste, cause the medical record to be inaccurate and the billing fraudulent or improper. The switch to ICD-10 may also lead to billing errors made by providers still getting used to the new codes.

AHIMA recently issued a position statement on the copy-and-paste function, suggesting that it be used with "strong" controls.

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