Tips to Help Physicians Switch to ICD-10

Jittery about using ICD-10 codes? Well, here are some tips for physicians that'll help them make a smooth transition to ICD-10.

It's practically not feasible to remember by heart all the codes that the ICD-10 code set contains. However you can take heart as switching to the new code set will not need practitioners to learn new code sets – in fact, most practitioners probably do not know ICD-9 codes by heart.

ICD-10 Tips for Physicians

In order to be all keyed up for ICD-10, physicians will need to take a look at the codes they use very often in their offices and come up with new job aids or superbills for those procedures. You will stand in good stead if you take a good look at the codes that you see most frequently in your practice. You can choose the top 30 diagnoses that they see and concentrate on knowing how to code those properly.


Here's what physicians need to do:

You should use your list of the top diagnoses that your practice sees to find the corresponding ICD-10 codes.

After this, see to it that coders are trained, that your claims are form 5010 compliant and that your claim submission system supplier is ICD-10 ready.

If you have an EMR or you plan to get one, see to it that it can handle ICD-10.

If you are beginning to bring an EMR, you should convert to ICD-10 first, and not bring one under ICD-9 and then convert.

You will not be able to glean ICD-10 codes from a physician's documentation if it is not thorough and detailed. Therefore physicians should take the opportunity to boost their documentation skills.

Note: The Centers for Medicare & Medicaid will very soon determine ways to process claims that span the ICD-10 implementation date.
For more ICD 10 coding tips, sign up for a good coding resource like SuperCoder. Such a site comes with an ICD-10 code lookup tool to help you in your coding.

ICD-10 Updates: Check Out New Options for Thyroid Disorders

While coding for thyroid disorders, here's what you need to keep in mind when ICD-10 goes into effect on October 1, 2013.

Although general rules of coding for both the code sets - ICD-10 and ICD-9 - will remain the same except for some subcategory variations, you need to stay up to date with these ICD 10 coding changes.

When it comes to thyroid disorders, here's how ICD-10 changes will have a say in your coding.

About thyroid gland: The thyroid gland is located in the front part of the neck; it produces the thyroid hormone which is important to normal metabolism. These disorders range from:

Hyperthyroidism: The thyroid gland becomes overactive here. It produces excess thyroid hormone and speeds up the body's metabolism. For hyperthyroidism, ICD-9 presently uses 242.

Hypothyroidism: On the other hand, here the thyroid gland becomes underactive. This happens if the thyroid does not produce enough hormones. ICD-9 currently uses 244 to report this.

In ICD-10-CM( Source "http://www.supercoder.com/icd-10/"), thyroid gland disorders are classified to these categories: E00 (Congenital iodine-deficiency syndrome), E01 (Iodine-deficiency related thyroid disorders and allied conditions), E02 (Subclinical iodine-deficiency hypothyroidism), E03 (Other hypothyroidism),E04 ( Other nontoxic goiter), E05 (Thyrotoxicosis [hyperthyroidism), E06 (Thyroiditis) and E07 ( Other disorders of thyroid).

Difference between the two code sets when it comes to coding for thyroid disorders:

Even though the coding rules related to thyroid diseases will be generally the same in ICD-10-CM as in the present code set, ICD-10-CM will classify some conditions to different chapters or different blocks. Say for instance ICD-9-CM's code for postsurgical hypothyroidism is 244.0, which is in the hypothyroidism category. In the new code system, you will not locate postsurgical hypothyroidism under category E03. In its place, you'll code it with E89.0, which is under category E89.

Tips for coders: A patient recently underwent surgery and radiation therapy for her thyroid cancer. The physician tends to this patient and carries out a level-two evaluation & management (E/M) and diagnoses her with hypothyroidism caused by the recent treatments. In this situation, you should opt for a more specific ICD-9 code than E03.9. When the patient has recently underwent thyroid surgery radiation therapy that caused the hypothyroidism, select the fourth digit based on the most recent factor affecting the hypothyroidism. For example , if the patient had surgery recently, choose E89.0. And if the radiation therapy was more recent, ICD-10 guidelines state that you would choose the same code.

How Lyme disease, ear pain diagnosis will change in 2013

Suggestion: Your diagnosis coding will depend on which ear was affected once ICD-10 hits. Since CMS has reiterated that it'll not push back the deadlines for the conversion to ICD-10, you will need to have your ICD-10 coding skills ready by October 1, 2013. Here are some examples of how ICD-10 will change your coding choices for two common conditions. Lyme disease Dx will need thorough documentation of attributable conditions

Right now, if a patient is confirmed to have Lyme disease, you report code 088.81 (Lyme disease). ICD-10 changes: With effect from October 1, 2013, you will find that the Lyme disease diagnosis codes have been expanded to include symptoms due to confirmed cases of Lyme disease, as below:

A69.20 (Lyme disease, unspecified)

A69.21 (Meningitis due to Lyme disease)

A69.22 (Other neurologic disorders in Lyme disease)

A69.23 (Arthritis due to Lyme disease)

A69.29 (Other conditions associated with Lyme disease) Documentation: Your doctor will need to clearly note whether the patient has Lyme disease alone (A69.20) or Lyme disease with other contributing factors (A69.21- A69.22). For example, you cannot use A69.21 unless the documentation includes confirmation that the patient ails from meningitis as well as Lyme disease, and that the two conditions are related. You shouldn't report the Lyme disease diagnosis code unless your practice gets confirmation from a lab test indicating that the patient tested positive for a Lyme disease. If you do not have a positive lab test confirming strep throat, you should simply use the diagnosis codes for the symptoms. As such, your documentation must include a copy of the laboratory report confirming that the patient had Lyme disease before you select your diagnosis code. ICD-10 coding tips: teach your practitioners about the just-in ICD-10 codes and let them know that documentation must indicate which specific Lyme disease diagnosis the patient has. Otalgia will need identification of affected ear To put it simply, otalgia refers to an ear ache. Part B practices often report otalgia diagnoses when patients complain of ear pain however no more definitive diagnosis is found. Presently, the ICD-9 manual offers just one code for unspecified otalgia: 388.70 (Otalgia, unspecified). ICD-10 coding changes: From October 1, 2013, you will be dealing with a series of four codes that describe otalgia, organized according to the location of the diagnosis, as here: Documentation: Doctors should already include the affected ear in their documentation. All you require to do as a coder to capture this already present information is to format your superbill to see to it that physicians document the additional anatomical information. Tips: You can arrange your superbill in a way that ensures that the physician documents all information applicable for you to submit the most proper code. For example, you can print it like this: H92.0x (x=1 for right ear, x=2 for left ear, x=3 for bilateral, and x=9 for unspecified ear) Or you can simply list "H92.0x" and have the doctor circle "left ear," "right ear," or "bilateral" on the form.

Article  Source  :- http://www.supercoder.com/coding-newsletters/my-part-b-coding-alert/icd-10-preparation-get-to-know-how-lyme-disease-ear-pain-diagnoses-will-change-in-2013-article