# ICD10 Training and Implementation



## maine4me (Sep 9, 2013)

Although, I have already started my personal training for ICD10, it came to my attention that the hospital I work for has not included the medical practices in the plan for ICD10 training and implementation.  So, I have now been asked to come up with a plan to prepare the medical practice physicians and staff, plus the billing staff for ICD10.  I am looking for guidance from any of you who have already begun this process, and how you are going about it.

Initially, the thought is to establish a group of coders (currently I am the only coder) to have them begin to code from the medical documentation, rather than the physicians determining the codes and giving them for charge entry via a fee ticket.  Taking the coding piece away from the physicians, will allow them to focus on documentation improvement and of course patient care.  I am not sure how many coders to budget for.  We have approximately 80 providers from many specialties, family practice, infectious disease, internal medicine (hospitalists), obstetrics and gynecology, wound care, palliative care, general surgery, cardiology, gastroenterology, and physical/occupational therapy.  I need to how many coders, should we look for coders in specific specialities, what are typical productivity requirements, etc.????

Any guidance is appreciated.


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## espforu (Oct 10, 2013)

We had started over a year ago and stopped with the delay.  Now we are back at it.  What we did first was create a list our commonly used ICD-9 codes per speciality.  We are primary care(Peds, Family, Women's Health) and converted them to ICD-10.  Then we did a audit to see if the documentation is meeting it, if not educating the providers. 

Now we are working on the actually process, which first comes with some obstacles!  
We are now looking at our encounter form (trying to get away from it!) and our software Vendor to see when they are going to be prepared and some ways to test.  

Then we will be educating our staff. 

Maybe you can help me as well.  Currently our providers are coding our records.  I then do quarterly audits and track their accuracy. With ICD-10 I would like to take this from our doctors(doctors are not coders) and create a coding department, I am trying to figure a process as when our poviders docuement in the EHR(Centricity) the ICD-9 code is linked to the diagnosis.  If a coder is coding the record, I am trying to figure out if the system can "turn this feature off".  Maybe you have some insight.  It is hard to ask the vendor as they are not open minded. 

I hope this helps!  Kim


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## maine4me (Oct 16, 2013)

Kim, 

What EHR are you using?  I do not know if this feature can be turned off on ours either.  Our family practice doctors are now actually selecting the ICD9 codes and the CPT, then they send the codes to the front desck via the system.  However, we are still using our encounter forms do relay information that cannot be relayed via the system.  There are many things our IT department can adjust for us in the EHR, since we share the system with the hospital.  If you do not have this resource I would imagine the vendor is your only option, unless another practices is using your same EHR and can provide guidance.

One of my managers thought we should hire a group of coders and try to transition to coders coding before the ICD10 implementation date, but another coder advised against this.  After thinking about it I am not sure I can train all of the current staff members and the doctors, plus try to find coders that are trained in ICD10.  So, I think I will try to work with the staff I have, and then maybe hire coders, not to code, but to provide ICD10 support for the doctors' coding.  

Either way this task is daunting.

Vickie


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## shaundra38 (Nov 23, 2013)

Start with your existing ICD-9 codes and create an ICD-10 crosswalk, NOW what everyone seems to forget is this. find the Indications that differ! This will not only indicate documentation changes but will indicate title changes, Laterality if it exist, deletions or addition of terminology whatever the case may be. Once this is done , create a document, new charge slip, day sheet , etc  this will be your foundation for your practice.


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