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Written by: Darlene D'Altorio-Jones (1959-2015) on Tuesday, July 23, 2013 Posted in: Inpatient Rehab

Everything you wanted to know about ICD-10 is at your fingertips with many of the resources provided by CMS.gov. Don’t hesitate; explore now and determine which resources are best to help your staff be ready! There is no better time than the present to help them ease into the changes they will experience in just over a year from now. We all know change is hard but educating purpose and preparation ensure improved adoption. This is big, let’s get started now.

Although it seems that Oct. 1, 2014, that next looming date for major change is far, far away; it is never too early to assess workflow and program changes that will need to occur to create the documentation and data sets required to be up-to-date. It’s no surprise our dedicated programmers and technical teams have been working on this transition and preparing our software for those flexible changes for the past couple of years here at Mediware. For those that got a glimpse of this upcoming tool at conference, you will learn a new (but familiar) word ‘widget’ to describe this new tool feature that will be rolled out to all accepting clients during the upcoming year.

What does the ICD-10 look like? Diagnosis coding under ICD-10-CM uses three to seven digits instead of the three to five digits used with ICD-9-CM, but the format of the code sets is similar,” per the CMS instruction page. In addition, CMS reports that transition to ICD-10 is occurring because ICD-9 produces limited data about patients’ medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated terms and is inconsistent with current medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full.

Clinically, documentation will need to support the specificity of the ICD-10 coding structure. The code sets were designed to code information that the ICD-9 set fell short to capture. The uniqueness enables initial, subsequent or a sequelae encounter to be recognized along with right/left, acute/chronic and in some instances whether a normal healing process is occurring or clinical issues such as delayed healing, non-union and or malunion complications have arisen in the care of the patient.

Much of this information will assist in the aggregation of data. Data that will enable improved clinical research comparisons, resource allocation and best practice outcomes when aligned with care CPT coding.  The World Health Organization (WHO) offers insights to international usage of the data. “In addition to enabling the storage and retrieval of diagnostic information for clinical, epidemiological and quality purposes, these records also provide the basis for the compilation of national mortality and morbidity statistics by WHO Member States. It is used for reimbursement and resource allocation decision-making by countries.”

The World Health Organization reports, “ICD-10 was endorsed by the Forty-third World Health Assembly in May 1990 and came into use in WHO Member States from 1994. The 11th revision of the classification has already started and will continue until 2015.”

A quick review of Wikipedia regarding ICD-10 gives you another set of abundant resources and facts to link to. Believe it or not, they report the creation of this version began back in 1983 (beating the birth of my eldest child by 3 years). It really should not be acceptable that as a world power, USA adoption has come late to the game.

When you consider that Nordic countries and the United Kingdom adopted use as early as 1994 and 1995 followed by a host of countries including Canada in 2001 – we are a dozen years overdue. What are we trying to hide? What will we discover? Get on board and let’s find out! Begin your education now for a smooth transition.

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