Home Health ICD-9/ICD-10 Alert

Tip: Fit in an anatomy refresher course before Oct. 2013.

You're not alone if you get overwhelmed just thinking about ICD-10. "All I can say about ICD-10 is 'Wow'!" says Matt Santangelo, RN, BSN, COS-C, HCS-D, with FirstLantic Healthcare in Fort Lauderdale, Fla. The idea of transitioning from the old familiar, but quirky, ICD-9 system can be unsettling.

Scary: ICD-9 includes 14,025 diagnosis codes, while ICD-10 boasts a whopping 68,069 for you to master.

But not everything will change, says Malinda Stanley, RHIA, MPA, CPC, CPC-I, AHIMA-approved ICD-10 trainer. Most basic coding rules will still apply, she says. And experienced coders will only need a couple of days for ICD-10-CM training. The PCS (Procedural Coding System) takes longer because the format is very different from ICD-10.

You should wait until early 2013 to take intensive training so you retain what you learn, but you can begin to become familiar with ICD-10 basics now.

Tip: Give yourself a leg up on the ICD-10 transition with additional training on anatomy, physiology, pathophysiology, pharmacology, and medical terminology, Stanley suggests. "If you don't use all of the specific body part terminology on a regular basis, it's helpful to have a refresher" before diving into the morespecific ICD-10 system, she says.

Changes underway: "Our local technical college has recently changed health information technology curriculum to make anatomy and physiology courses mandatory, where before students had a choice between a human body course and anatomy and physiology," says Jean Burkart RHIT, HCS-D, Coding Technician II with Northwest Wisconsin HomeCare.

Most coders may be able to wait a few years before kicking ICD-10 training into high gear, but your organization leaders and educational instructors should start preparing now, Stanley says.

"My supervisor has been going to meetings to identify who needs training and to what extent," says Burkart. Agencies that plan ahead like this will have a better chance of staving off problems before they begin.

The transition to ICD-10 will impact billing, reimbursement, data collection, reporting, and training. A successful transition plan will consider each of these aspects, Stanley says.

Tip: After the transition to ICD-10, the assessing clinicians will need to be as specific as possible with regard to diagnoses as they take the history from the patients, Santangelo says. Details like right side, left side, upper, lower, etc. will be even more important in code selection, so working to gather thorough documentation now may head off headaches at transition time. "I forecast that there will be more phone calls to the physician's office to get a clearer picture of the patient's diagnosis," he says.

Now is the time to check with your software vendor to see how they are preparing for the transition. Find out now whether the vendor will be charging a fee for the update.

Agencies on a point of care system need to start asking their software provider specifically how they are getting ready for the transition, Santangelo says. For example, home care agencies may even need both ICD-9 and ICD- 10 loaded into their system for the transition. Will your vendor be prepared?

If your vendor doesn't have an ICD-10 transition plan in place, you may want to consider changing vendors, Stanley says.

The first step in the transition for your software vendors is to change the electronic claims format to version 5010, says Lisa Selman-Holman, JD, BSN, RN, HCSD, COS-C, consultant and principal of Selman-Holman & Associates and CoDR --" Coding Done Right in Denton, Texas. That transition begins January 1, 2011 and all providers, including home health agencies and hospices, must be transitioned before January 1, 2012.

The new 5010 version will accommodate the longer, more detailed ICD-10 codes and actually have 25 diagnosis field locators, Selman-Holman adds. CMS recommends that software vendors make this transition well before the January 1, 2012 deadline.