# ICD-10 Documentation Specificty



## psiebken (Sep 18, 2013)

Our ICD-10 Project Manager, is getting lots of push back from the physicians regarding ICD-10 training and their need to document and assign diagnosis codes to the highest level of specificity.
Their first request is to NOT code and have coder's assign the dx codes.  That would be ideal but unfortunately we would not have capacity to do this so it is not an option at this time.  

She would like the coders help in finding any articles/documentation supporting the need for specificity on the professional side.  There is a lot of information specific to ICD-10 facility coding and documentation  but it has been hard for her to find anything that spells out exactly what will be required on the professional side.  Others have researched and attended many webinars and have not found anything specific to the Pro side either.   The Project Manager has a meeting with the Physician ICD-10 Subcommittee and would appreciate any information we have. I believe her meeting is Wednesday, 9/18.

If you have any links or anything pertinent, please forward to me.  Cut and paste is fine as long as there is a reference/resource.


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## mitchellde (Sep 18, 2013)

Why is it impossible for your coders to code?  This is the most ideal arrangement in my opinion.  Your providers time is more valuable than to try to decide which code to select.  If the coders would practice even as little as 1 hour a day assigning the ICD-10 codes, they would be able to provide intelligent feedback to the providers regarding the specificity of the documentation.  I am agreeing with your physicians on this.  If you have coders there is no reason why they should not be able to examine the documentation to determine the correct code.


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## JEYCPC (Sep 19, 2013)

I wonder if psiebken means that the coders can't assign ICD10 because the documentation is lacking specificity?  I can empathysize.


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## BlakeCarswell82 (Sep 19, 2013)

http://www.icd10monitor.com/index.p...kIGNhcmUiO2k6MTM7czoxMToic2hvdWxkIGNhcmUiO30=

I have found ICD 10 monitor to be incredibly helpful in providing articles that tell you WHY the doctors should be more specific.  Let them know that reimbursement is only part of it.  The codes are also used in research, and we want that to be as accurate as possible so we can get resources where they really need to go.  Also, ICD 10 should help in patient care.  Obviously, if the documentation is more specific we can get their claims paid easier, and the doctors can monitor that their care is helping the patient and the patient's conditions are not getting worse.

As for the coding aspect, I have discovered that if the doctors specify laterality (left, right, and bilateral) they have already accomplished about a third of the changes in the ICD 10 book.  Start with easy stuff first and get a "buy in" from the physicians.  Then move on to things like specifying complications and manifestations of diseases after you get them a little more used to the idea of change.  Good luck!


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## BlakeCarswell82 (Sep 19, 2013)

Also, AAPC has online courses that are for the providers that will help them learn what is needed.  It is rather expensive, but not being ready for the transition will be far worse.


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