With only five months to go until the implementation of ICD-10, the countdown is on for physicians, and other clinicians to be educated on the nuances of this new code set.
Breadth and Depth of Training
Training in ICD-10 is being offered by many different companies in multiple formats, such as online learning, face-to-face workshops, textbooks, or webinars. With all of these different options, the first step is for the physician to determine the depth of ICD-10 training needed. A few questions to ask:
• Will the physician be assigning codes in ICD-10?
• Does the physician have coding staff to assign the codes, but needs to be educated on the documentation requirements for ICD-10?
• Are there other clinicians in the practice, such as nurses, therapists, etc., that need training on ICD-10 documentation requirements?
Depending on the work flow of the practice, the physician may or may not be responsible for selecting the diagnosis code(s). If the physician is selecting the ICD-10 code, either on a superbill or within an EHR, a detailed course/training covering guidelines and conventions of ICD-10 may be in order. However, if the physician has coding staff that assign the diagnosis codes based on the documentation, the focus of training should be on the nuances of documentation for ICD-10.
The ICD-10 classification system includes many more codes than ICD-9, which at first may be daunting to the clinician. However, when taking a closer look, much of the expansion of the code set is due to the addition of laterality, which is hopefully already being documented. Clinicians who currently have high-quality documentation will likely experience a very smooth transition to ICD-10, with minimal documentation changes necessary.
Another factor to consider is the breadth of training. For instance, a cardiologist may only be interested in learning about diagnosis codes pertaining to the cardiology specialty, whereas a family-practice physician may want a more comprehensive training covering all body systems.
After determining the depth and breadth of ICD-10 training desired, the next step is to look at the delivery mechanism. There is not a one-size-fits-all ICD-10 physician training program. Comparing and contrasting the different types may assist in selecting the best option.
Attending a workshop or hiring an expert to do the training is probably the quickest method; however, it could be the most costly. Many companies and individuals offer training in ICD-10, and some tailor it to specific needs, such as physician documentation requirements. Having an expert come to the practice to do the training allows for individualized, practice-specific training. One valuable exercise would be to have the expert trainer review the current clinician documentation and identify gaps in documentation that need to be remedied for ICD-10 readiness. This exercise of documentation analysis could even be done by an internal coding staff member that has received extensive ICD-10 coding training.
The flexibility of taking courses online is attractive to many and the cost is typically lower than a face-to-face training. Busy clinicians may prefer to take an online course at their leisure, as time allows. However, finding an online course to meet a practice's individual documentation needs may be a challenge.
Another form of training that doesn't require travel is webinars. Oftentimes, these webinars are recorded and may be viewed at any time, allowing for great flexibility for the time-strapped healthcare professional. Webinars are great for learners who like to both see and hear the material being presented.
Probably the least expensive option for training is to purchase a textbook from a reputable ICD-10 training company. Be sure to review the content of the textbook to determine if it is geared toward coders or clinicians. A textbook for coders may be too granular for the average clinician who needs assistance with documentation requirements, not coding guidelines.
Putting Training into Practice
Once the training is complete, the physician must practice what was learned. Many EHR vendors are offering the option to practice coding in ICD-10, which might be ideal for that clinician wanting to preview the codes and get a feel for the necessary documentation. If the physician is working in a practice that has coders assign the codes, then the physician should work together with the coder to ensure that the documentation in the record is specific enough for accurate ICD-10 code assignment. Ideally, physicians and coding staff should work together to ensure that the documentation is ready for Oct. 1, 2015.
A physician practice that has implemented an ICD-10 communication plan, developed a budget, completed staff education, performed readiness testing, analyzed documentation, reviewed quality reporting requirements, and is working on physician education on ICD-10, is on a positive pathway to implementation. Oct. 1, 2015 is quickly approaching and time must be used wisely.
7 Big Changes for ICD-10
Focus on the most frequently used codes at your practice — such as these seven — to better prepare your primary-care practice for the ICD-10 code set transition. Visit bit.ly/icd10-and-primary-care.
AHIMA ICD-10-CM/PCS Implementation Toolkit: http://www.ahima.org/topics/icd10
AHIMA ICD-10 for Physicians and Clinicians: http://www.ahima.org/topics/icd10/physicians
AHIMA 2015 ICD-10-CM Coder Training Manual: https://www.ahimastore.org/SearchResults.aspx?SearchString=ICD-10
CMS Provider Resources: Road to 10: http://www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html
Melanie A. Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA is a senior director of HIM Practice Excellence at AHIMA. Email her at [email protected].
© 2015 American Health Information Management Association (AHIMA). Reprinted by permission.