How the ICD-10 delay could lead to smarter documentation

Provider organizations can make good use of the extra year they've been given to transition to the ICD-10 diagnostic set, Heather Haugen, vice president of research for Xerox subsidiary The Breakaway Group, said in a recent interview with Healthcare IT News. Some of this has to do with preparing for the changeover, but hospitals and physicians also could be figuring out smarter ways to document care and use the code set to improve quality, she said.

Among other things, Haugen noted, organizations can give coders the opportunity to "practice" on ICD-10 before going into production mode. They also can encourage physicians to begin documenting encounters in their electronic health records at the more granular level that ICD-10 will require, even while coding in ICD-9. And doctors could be shown how ICD-10 coding can help improve decision support and aid medical research--two reasons for them to support the switchover.

Most important, Haugen pointed out, ICD-10 transition leaders can use the extra time to figure out how to "narrow the choices" in EHRs so that the burden of documenting to match tens of thousands of new codes doesn't fall so heavily on physicians.

"Ensuring that in the EMR we're only giving clinicians the information they need in those cases will help them," Haugen said. "As I was talking to some of the folks that work in the standards world, and others, they were saying there's no reason why we should be presenting clinicians with these enormous code sets. Instead, we should be doing a better job giving them the information they need at the time they need it--and that's even on the EMR vendor side."

Haugen added that she believes some vendors are "hoping to provide tools and information around improving documentation to make some of this easier."

Meanwhile, Ann Zeisset, a consultant who provides coding advice to members of the American Health Information Management Association, told attendees at a session last week at the American College of Physicians' annual meeting in New Orleans that proper training is vital to an effective ICD-10 implementation, Medical Economics reports. She added, though, that providers first must establish a capable team and determine a strategy before jumping in.

"Any delay in doing these steps will jeopardize your ability to be finalized with your implementation timeline," Zeisset said.

The Centers for Medicare & Medicaid Services (CMS) recently proposed delaying the deadline for universal adoption of ICD-10 from Oct. 1, 2013 to Oct. 1, 2014. Two months earlier, when CMS announced it would postpone the deadline, the agency said that it was responding to signs that the healthcare community wouldn't be ready in time to meet the original deadline.

Provider reaction to the one-year postponement was mixed, with hospitals generally relieved and physician associations saying that it was a good step but not adequate to alleviate physician concerns. The biggest issue for doctors has been, and remains, the extra time they perceive it will take them to document encounters.

To learn more:
- read the interview in Healthcare IT News
- here's the Medical Economics article

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