ICD-10 – Making the Switch

icd10ICD-10 is the largest healthcare mandate in history and while many healthcare professionals are concentrating on ObamaCare requirements, just as many and more are focusing on ICD-10 requirements as meeting them is directly connected to their revenue stream.  Documentation requirements are high, but the shift can be made easier with proper planning and implementation.

  • Assess staff training needs – make sure every member of your team has received the education necessary to make the change
  • Review your superbil – do you list diagnosis on your superbill? If you do, you will need to re-customize
  • Automate your superbill – software such as Medisoft, Lytec or Greenway Prime Suite allows for this. Medisoft versions 19 and 20 and Lytec versions 2014 and 2015 offer a free mobile app for the iPhone and iPad that allow you to use an electronic superbill (this is a great idea for physicians that don’t have EHR/EMR that send billing codes to the billing system)



  • Is your EHR software ready to go? Talk with your vendor about all the new changes in their systems to accommodate the requirements
  • Discuss implementation with your billing services to make sure all will be in sync
  • Identify practices and workflows that may need to change
  • Budget for time and costs associated with ICD-10 requirements
  • Conduct test transactions

Richard Garcia, MD, MPP, MHA, Emergency Department Director at Beverly Hospital in Montebello, California is a practicing emergency department physician and passionate health IT junkie.  Dr. Garcia took CDI and ICD-10 coding into his own hands, developing software templates and serving as an evangelist for better documentation.  He feels that while there is a lot of documentation out there for clinical conditions (ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification)), that there is not much regarding ICD-10 Procedure Coding System (ICD-10-PCS).  And he feels that because PCS is so clinical, coders may have a hard time.

Dr. Garcia also tries to remind doctors that the small amount of extra time (maybe 15 seconds worth) that the initial correct coding will take is worth it.  He states, “How long is it going to take when you’re walking down the hall, and you see your CDI specialist, and she says, “Dr. Jones, you forgot to document this case?”  You’ve got to walk back to your computer.  You’ve got to log on.  You’ve got to go into that account number.  You’ve got to find where in the medical record you’re going to document it.   You’ve got to write down the information.  Maybe you remember everything about that patient, and maybe you don’t.  So now we’re talking quality of documentation.  That takes a lot more than 15 seconds.  It might take longer than seven minutes.  How much time do you lose when you don’t do it right the first time?”

A survey by the American Health Information Management Association (AHIMA) reported that 61 percent of clinics and physician practices believed that documenting patient encounters would be harder, and for adjudicating reimbursement claims, 54 percent of practices thought ICD-10 would make the process more difficult.  The report also states that organizations may better recognize the potential benefits of ICD-10 as they grow more familiar with the code set.

D’Arcy Guerin Gue, an ICD-10 consulting professional and journalist, recently wrote, “The time for weighing in on the negatives – initial costs, complexities, and changes – is over. Organizations that have set this bar early on have already achieved benefits, such as more accurate documentation and resulting cost savings. Their insistence on early physician engagement has also eased apprehension and helped provide a window into the actual impacts ICD-10 will have. While your institution may not have been one of the early ICD-10 movers and shakers, there’s still time to become one.”

For Greenway PrimeSuite and McKesson Practice Choice users, the transition will cause minimal worries as the EMR systems are up to date and offer intuitive reports and tools to help end users.