Series on Lessons Learned Following ICD-10 Adoption Debuts Today

The five-week series will highlight progress made during the implementation of the coding set that became effective Oct. 1, 2015.

ICD10monitor and Talk Ten Tuesdays are poised to embark on a five-week series, “Five Looking at Ten,” that will focus on the lessons learned during the adoption of ICD-10 that can be applied to the imminent adoption of ICD-11.

“Each week, a healthcare professional will address lessons the industry has learned, as America’s healthcare system enters year five of the adoption of ICD-10, which became effective on the first day of the government’s fiscal year, Oct. 1, 2015,” said Chuck Buck, ICD10monitor publisher and executive producer, and host of the long-running Talk Ten Tuesdays broadcast. “We will be reporting on topics related to coding, the American Hospital Association’s (AHA’s) Coding Clinic, and the Coding Guidelines, as well as work done by coding consultants and auditors.”

The series begins today on Talk Ten Tuesdays with an appearance by Denise Buenning. Buenning, now retired from healthcare, at the time of the run-up to ICD-10 served as the deputy director for the Centers for Medicare & Medicaid Services (CMS) Office of E-health Standards & Services.

Also participating during today’s live broadcast will be Laurie Johnson, a senior healthcare consultant for Revenue Cycle Solutions, LLC, and Donna Rugg, Director of Health Information Management (HIM) Practice Excellence, Terminology Mapping, Coding, and Data Standards for the American Health Information Association (AHIMA). Rugg will address lessons learned with clinical documentation integrity (CDI) under ICD-10.

“The transition to ICD-10 was a wake-up call to how insidious the medical codes had become in healthcare,” Johnson wrote in an email to ICD10monitor. “I believe that we found that many organizations were using diagnosis and procedure codes (improperly).”

According to Johnson, many different applications had to be considered due to the pervasiveness of the classification system, and the industry had to consider the impact of ICD-10 implementation on the electronic health record (EHR), clinical documentation integrity (CDI), coding, state-reported data, quality-reported data, various reimbursement methodologies, case management, regulatory guidance (e.g. National Coverage Determinations and/or Local Coverage Determinations), health information management, grouping software, billing forms (e.g. 1500 and UB-04), and marketing.  

“It was also realized that there must be a tool to convert ICD-9-CM codes to ICD-10-CM/PCS, as well as ICD-10-CM/PCS to ICD-9-CM,” Johnson said. “As we talk about the impending transition to ICD-11, I have looked back at what … we (learned) about training and education.” 

In that vein, Johnson offered these recommendations:

1. Begin to train early. Doing so promoted early adopters assisting in training others. Early training also generated education creativity. Varied approaches to training allowed the trainers to create interest and attract other students.
2. Adapt to the learning style. Adult learners gain knowledge differently than younger students. Trainers have to be able to adapt to class demographics to produce optimal education.
3. Create consistent learning tools. AHIMA and AAPC authored education classes that had pre-developed content.  
4. Remember that training must be available online. As the skill set need grows in healthcare, there must be more Internet offerings due to the number of students, as well as increasing travel costs.

“Training is an ongoing activity,” Johnson said, “but the initial training is so important to the adoption of any new classification system.

Nationally recognized HIM expert Gloryanne Bryant will also participate during the five-week series. Bryant, former president of the California Health Information Association (CHIA), is scheduled to report on lessons learned from the official guidelines and AHA Coding Clinic. Bryant will also report on lessons learned regarding audit and coding vendors.

“We appreciate that Change Healthcare will be sponsoring this five-week series,” Buck said. “It is obvious to them that the lessons learned from ICD-10 will have a profound impact on hospitals and health systems as the nation prepares for ICD-11.

Also scheduled to appear during the Oct. 22 Talk-Ten-Tuesdays broadcast will be Robert M. Tenant, director of health information technology policy for the Medical Group Management Association (MGMA).

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