Neurosurgery Coding Alert

Gear up for more specificity; do not ignore trainings.

You have now adopted and implemented ICD-10. Goes without saying, you have faced some challenges doing so. With the staff and systems still new to ICD-10, you may not be sure how you will survive this change.

Experts advise on how to meet the ICD-10 challenges. Alicia Scott, CPC, CPC-I, CRC, a trainer with Certification Coaching Organization, LLC, in Oceanville, N.J. has had experience turning the potentially grueling task of ICD-10 training into something a lot more prolific and productive.

Get an ICD-10 Expert to Explain New System

If you haven’t already, your practice should have an ICD-10 expert “come in to talk about their questions. … [To] make sure they see ICD-10 as a good thing for the entire office,” recommends Scott.

She says that once coders and providers learn the new system, they will find that “ICD-10 is amazing, and even though there are going to be some bumps, coders are going to fall in love with it.”

Rationale: The guidelines in ICD-9 and ICD-10 are the same for the most part; ICD-10 is just far more specific. This specificity benefits coders and providers — once they get past the learning curve.

During her talks with medical coders and providers on the ICD-10 switch, Scott offers this analogy: “ICD-9 is like learning to drive your grandfather’s old five-speed pickup truck on the farm, and ICD-10 is like driving a Cadillac. The guesswork is gone; it is all spelled out for you now,” she says.

The rub, however, is getting everyone the supplies and training they need to deal with the first year of ICD-10. “It is important to understand that not allow ICD-9 codes translate to a single ICD-10 code.  The greater specificity of ICD-10 may require you to learn additional diagnostic codes to describe the typical conditions you treat,” says Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison.

Deliver Paper Copies for Coders

The cause for much ICD-10 anxiety, in many cases, is a lack of a paper copy of the ICD-10 manual. Scott recommends purchasing ICD-10 books for the entire coding staff.

“Each of your coders needs an ICD-10 manual to hold onto and make notes,” Scott says.

Further, looking at a paper copy can help alleviate some of the ICD-10 fears, she says.  When coders look at the paper copy of ICD-10, they often discover “that codes are found in the ICD-10 manual in the same areas [as the ICD-9 manual]. The chapters didn’t change locations.”

Bottom line: Once coders get a look at a paper manual, “they will see the benefits” of ICD-10, Scott explains.

Promote Communication with Weekly Practice Sessions

Every ICD-10 coding expert will tell you that communication between coders and providers is vital toward success with the new system. Creating forums where that communication can occur may be beneficial. “Fortunately, most practices regularly use only a small subset of diagnostic codes, typically in the range of 30-40 commonly treated diagnoses,” Przybylski says.

Try this: Create an ICD-10 coding practice session, “where [coders and providers] have weekly meetings and go over unique cases with explicit rationales,” Scott recommends. This will give both coders and providers a forum to ask questions and form opinions about important ICD-10 issues without interruptions.

If providers and coders don’t communicate, “then you are going to suffer with ICD-10,” warns Scott. If not weekly, your practice’s best bet is to set up some kind of regular meeting between providers and coders to go over any ICD-10 issues they encounter.

Get involved in your local coding organization chapters. This is a great way to listen, learn, and input regarding ICD-10.

Stoke ICD-10 Interest with Dx Coding ‘Games’

Another way to foster communication between coders and providers is to try and inject a little fun into ongoing ICD-10 training.

Do anything you can to promote a positive attitude around ICD-10, Scott recommends. “Have fun with it. Have a ‘Crazy ICD-10 code of the week’ … or something else fun.”

Other fun ICD-10 training activities include:

• ICD-10 “Jeopardy”: Stage a “Jeopardy”-style game show that tests ICD-10 coding knowledge. The winner gets a small prize.
• Group Coding: Split up into teams and work on providing ICD-10 codes based on mock encounter forms. The team that gets the most ICD-10 codes right wins a small prize.
• Crosswalk Challenge: Give everyone a list of ICD-9 codes and descriptors, and instruct them to convert the codes to an appropriate ICD-10 code using a crosswalk. Give the employee who gets the most codes correct a small prize.