As discussed in my May 2012 blog, only diagnosis codes will change for physician practices and medical groups under ICD-10, not procedure codes. And while physician payment is not driven by diagnoses codes, they are still required to show medical necessity. This is where practices must be thoroughly prepared to make the leap.
It’s important for physicians to understand ICD-10’s impact and how it can ultimately benefit quality of care and their practice.
Explain the Benefits of Greater Specificity
ICD-10 incorporates greater specificity, clinical data, and information relevant to ambulatory and managed care encounters. In addition, the structure of ICD-10 allows for the expansion of code numbers. ICD-10 also extends beyond simply the classification of disease and injuries. It includes the ability to code risk factors that are frequently encountered in a primary care setting.
ICD-10’s magnified degree of specificity provides more detailed information encouraging and supporting providers, payers, and policy makers to:
- Establish appropriate reimbursement rates.
- Improve the delivery of healthcare.
- Improve and evaluate the overall quality of patient care.
- Effectively monitor both service and resource utilization.
Invest in Physician Champions
It will be difficult for physicians to embrace ICD-10. Change is difficult and the transition may be costly. Therefore, HIM professionals and group administrators must focus on helping physicians understand the dynamics involved with the new code sets, and the greater level of specificity required.
To do this, organizations are advised to first identify and invest in the development of a few select physicians. These physician “champions” should understand the ICD-10 processes and support the transition. Let their knowledge of ICD-10 model change for other colleagues who may resist migrating from ICD-9 to ICD-10.
With a little education, encouragement and support all your physicians can successfully make the leap!