Imagining the first few days of ICD-10 might feel much like encountering a great white shark in the shallow waters of your favorite beach. One minute you are enjoying the calm water and cool breeze and the next thing you know, panic sets in as you notice the man-eating killer lurking closer than you would like. Naturally with this panic comes a lot of screaming, splashing and commotion drawing the shark’s attention toward your direction. With only days to go until the implementation of ICD-10, this is definitely not the comparison we would like.
During my Marine Corp days, we performed training missions in the ocean and here is the advice the instructors gave out if a shark was spotted:
- Stay calm
- Don’t make any sudden movements
- Swim slowly from the area
- If the shark attacks, be as aggressively defensive as possible and do not play dead because sharks do not play that game
- Once you get out of the sharks mouth swim like “HELL”!
You might feel like you are in the death grip of the rapidly changing world of HIM. However, you too can survive this quickly approaching challenge.
Manage the first few days of the ICD-10 transition by keeping these thoughts in mind:
1. First and foremost, stay calm! Staying calm is key to any major change. It’s important to remember that diagnoses, procedures, and coding guidelines have changed every year for decades. Trust your training and know that the transition to ICD-10 is a standard part of your career growth and development.
2. Avoid assigning ICD-10 codes too hastily and possibly over utilizing the unspecified codes. Be prepared to spend a little more time on assigning the most appropriate codes. Be on the lookout for specificity and laterality. Specificity is by far the most impactful change and affects the documentation required to support the disease processes, types, and locations. A valid code is one that is carried out to the highest level of specificity based on the medical record documentation.
3. Be prepared for a lag in productivity, but don’t be discouraged. In the beginning, coding in ICD-10 may impact the speed in which you typically code. Ask your employer what the expectations are for overtime and have a clear understanding of how your facility plans to manage backlogs.
4. Knowing the definitions of each root operation and the intent of the procedure being performed is key to assigning accurate procedure codes. In order to do this you need to understand the intended outcome of the procedure.
5. Rely on your resources. In the final weeks leading up to ICD-10, I recommend earmarking your books to any pages or chapters that you think you might need to reference, so you’ll be ready on Day 1. This organization will help with your productivity and sanity in the first days of the transition. Keep ICD-10 coding books, Coding Clinic’s and reference close enough that they can be easily reached when you need them.
6. Discuss coding scenarios with your team. Using collective experience to solve a problem can help everyone in the ICD-10 environment work more efficiently. Consider scheduling time once a week or so to meet with a small team of managers and coders to discuss any initial obstacles, or documentation practices that need to be addressed quickly. Sharing these experiences within the team with help smooth out the transition.
Most of all On October 1st remind yourself these two things:
- I am an HIM professional able to overcome any challenge.
- I knew how to code yesterday (September 30, 2015) and today is not any different!
Now get out of the Jaws of ICD-10 and code like “HELL”!
Do you have any other advice as we near the transition? If so, leave it in the comments. I'd love to hear them!