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Six Smart Things to Do Before the Transition to ICD-10 Coding



ICD 10 code transition copyIt's not a secret...."Health care is changing."  But how?  Why?  In an effort to improve patient care, the 1996 HIPAA law included a requirement for the adoption of a more specific way of coding patient diagnosis codes.  Currently, health care providers use an ICD-9 coding system which utilizes a set series of numbers and decimal points to identify a patient's condition.  For example, a medial knee sprain is listed as 844.1.   On Oct 1, 2014 this number will be replaced by S83.419A as part of the new ICD-10 coding system. 

The HIPAA law was enacted to create change not only in how health care is delivered in the USA.  It also included requirements to ensure security of patient records and the standardization of how these records are kept so that doctors, hospitals, therapists, and other health care professionals could communicate with each other.  The intention was to improve patient care by ensuring those responsible for your care had the most current...and complete information.  These include lab tests, MRI's, surgical reports, and other vital medical info.  HIPAA requires that all this information is readily available to those who need it....and yet kept secure to allow only limited access to those the patient has granted permission.  Since 1996 HIPAA has given patients the right to determine who has access to their medical records.  EMR (electronic medical records) are another part of the original HIPAA law.

As with all major changes, ICD-10 is not without controversy.  The cost incurred to make these coding changes is no small matter....requiring training for all involved, adaptations in how a patient visit is documented, software to handle new codes.  The end result will be a much more specific record of the patient quickly accessible to their provider.  The change is significant, transitioning the current 14,000 ICD-9 codes to more than 67,000 new ICD-10 codes.

Whether you are working with physical therapy documentation software or an EMR for a general practice, these will ensure a smooth transition to the ICD-10 system

  1. Make a list of the top ICD-9 codes frequently used in your practice
  2. Check to see if each of these codes has an accurate 1:1 match to an ICD-10 code.  If not, determine which ICD-10 code or codes are the best choices for your practice needs.  Example: in ICD-9, a dislocated thumb was included with the same code for a finger dislocation (834.00).  In ICD-10, the thumb now has its own code (S63.106A)
  3. Offer training to your entire staff - clerical to practioners
  4. Implement an efficient EMR system to ensure accurate documentation to match your coding and capable of supporting dual coding of both systems during transition
  5. Let your patients know there may be some changes in their statements
  6. Be prepared for delays in claim reimbursement during the transition

The good news is.....in the long term patient care will be improved.  Hence, outcomes will improve.

  • With more current information available to the health care provider, better decisions can be made.
  • Doctors, therapists, technicians can communicate directly with each other across long distances without waiting for return calls or appointments.
  • More precise ICD-10 coding ensures the diagnosis is as specific as possible and allows it to be changed if new information so indicates.
  • The initial financial cost of this transition will be recovered in less expensive quality patient care in the future.

Change is coming to health care, but the primary goal needs to remain the same.... "the patient comes first."  Whatever changes are made, we must always remember we are treating people.....not potatoes.                       


Diana welcomes your comments


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Diana Echert

Jumping for PT DocTools

Diana is a licensed physical therapist whose experience spans inpatient and outpatient work in rehab, geriatrics, orthopedics and sports medicine. An avid hker and tennis player, she you must practice what you preach.  Stay active and informed any way you can

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