With ICD-10 clearly visible on the horizon, we sat down with ICD-10 Trainer and Educator, Cortnie Simmons, MHA, RHIA, CCS, CDIP, to discuss what ICD-10 looks like from a trainer's perspective.
Cortnie discusses preparedness, common questions, and available resources.
How prepared are the majority of the coders you are seeing?
Coders have the biggest challenge in learning the ICD-10 CM and PCS system, however most coders are used to the continued education needed in the coding profession. We have been trying to move toward ICD-10 for a number of years and most coders started looking at the ICD-10 coding system some time ago.
What is important to note is that the CM and PCS system are completely different. ICD-10 CM has a very small learning curve as the foundation is similar to what coders have been doing for years in ICD-9 CM and I believe coders will be prepared. In contrast ICD-10 PCS has a significant learning curve. I believe that coders will be foundationally prepared for ICD-10 PCS, however practice is the best confirmation of this. Learning the system’s foundations and applying it through application may be significantly different. Application is going to allow us to see the issues with coding or documentation and be able to determine how to perfect any processes. Coders and organizations that are planning or conducting dual coding will achieve better awareness and preparation for ICD-10 go live in October.
What are the most common questions, and where are you seeing the most difficulty for medical coders?
The most difficult part of ICD-10 for coders will be in the ICD-10 PCS system application. I'm seeing coders struggle with the definitions of root operations, approaches, and associated ICD-10 PCS guidelines and how they apply to procedural documentation. The PCS system represents the challenge of understanding the system and applying it to the documentation that providers provide in the medical record. There will be significant times when a provider uses certain terms during a procedure that will not meet the definitions in the ICD-10 PCS system and the coder will have to interpret and apply the appropriate definitions and guidelines. In addition, it will be extremely important for the coder to completely understand what was done during a procedure. For instance, what was the intent? What was excised? What was the approach to the operation? Understanding this information is going to result in proper coding application and not understanding will result in improper coding, payment, and possible denials. These areas will be a huge challenge for coders.
What resources do you advise coders and their facilities take advantage of?
The good thing is that there are a lot of great resources available for ICD-10 CM and PCS. There are a number of organizations that have created books, applications, and other materials that will assist coders and other stakeholders (CDI, providers) with understanding and preparing. My best advice is to understand what areas may be gaps for you in ICD-10. Is it ICD-10 CM? Is it PCS? Is your challenge root operations or approaches? Once you determine your gaps and continued education needs finding the best resources to assist with this is beneficial. For instance if you need more practice and you want to do practice coding scenarios there are books that have great case studies to help you practice coding and provide you with answers and reasoning for learning . If your gap is more understanding the definitions and methodology of CM and/or PCS I would suggest training manuals, applications, flash cards, and even code books. These are all great resources. If your gap is in documentation and Clinical Documentation Improvement you may want to search for books that provide you with great detail on interpreting clinical documentation needs specifically for ICD-10. There are a number of resources and as coders we need to invest in ourselves to ensure that we get what we need to continue to do a great job in the ICD-10 environment.