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6 ICD-10 Myths That Could Affect Your Office Workflow

Posted by Megan Ludzenski on Mar 4, 2015 10:00:00 AM

ICD-10 is set to replace ICD-9 on October 1st of this year. There has been a lot of talk in the health community about how the implementation of these new codes will affect healthcare providers and office workflow. Since it can be hard to sort through all of the information online, we want to try and clear things up for you a bit.

The CMS released a document responding to ICD-10 myths that have been floating around, and we pulled what we think are the top seven. Today, we are going to bust these myths so that you can feel assured your office workflow won't suffer come October 1st; it might even improve!

ICD 10 Office Workflow Myths

7 ICD-10 Myths You Should Understand to Keep Your Office Workflow Running Smoothly


Myth #1
: The Department of Health and Human Services will likely grant an extension beyond October 1, 2015.

Truth: All HIPAA entities must implement the new codes for patients seen on and after October 1, 2015. The Department of Health and Human Services does not plan on granting extensions, so we encourage you to take the time now to prepare your practice for the change.

Myth #2: Practices will have to use ICD-10 for external cause code reporting even if they haven’t been reporting external causes on ICD-9.

Truth: While listing external causes can be useful for injury research and prevention, your practice will not be forced to use ICD-10 for external cause reporting. The exception to this is if your practice is subject to a State-based external cause code reporting mandate, or the codes are required by a payer.

Myth #3: The increased number of codes in ICD-10 will make it impossible to use.

Truth: Having a greater number of codes will make it easier to find the appropriate code. There are also electronic coding tools and an alphabetic index that are there to make it easier to search for the right code quickly. The idea behind having a greater number of codes is to have more specific and accurate codes which will create better patient care. Besides, your practice won’t be using every single code in ICD-10, you’ll be selecting from a small number of codes that are specific to your specialty and practice.

Myth #4: ICD-10 was developed years ago, which means it is probably already out of date.

Truth: ICD-10 codes have been updated annually since their development to keep up with the advances in medical technology. The Department of Health and Human Services also plans to continue to update the codes with the first scheduled update to take place October 1, 2016. 

Myth #5: Unnecessary detailed medical record documentation will be required after implementation.

Truth: The codes your practice uses in ICD-10 will be based on medical record documentation. These codes are designed to be more accurate and specific, resulting in higher-quality data. Just like in ICD-9, there will still be nonspecific codes in ICD-10 for when documentation doesn’t support a higher level of specificity, however much of the detail in medical record documentation is contained in ICD-10.

Myth #6: GEMs are for Medicare use only.

Truth: The General Equivalence Mapping (GEM) tools are a set of tools that convert data from ICD-9 to ICD-10 and vice versa. These tools act as crosswalks between the two code sets and were developed for all providers, payers, and data users. GEMs are free and in the public domain. While GEMs are useful in linking concepts between ICD-9 and ICD-10, they are designed to do so by mapping, without consideration of patient medical record, and therefore should not be used for help with coding. Simply put, GEMs will help your practice convert data from ICD-9 to ICD-10 during implementation, but you’re still going to have to learn the ICD-10 codes moving forward for medical documentation of patients. 

Those are the top 7 myths related to your office workflow that we felt could be confusing users. If you want to view all of the myths CMS has answered, you can check them out in thier Myths and Facts document.

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