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ICD-10 for Providers

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ICD-10 FAQs

  1. Why does this need to happen?
  2. How does ICD-10 improve patient care?
  3. What’s expected of employees?
  4. How does this coincide with eMERGE, BMC’s new electronic health record system?
  5. Who is affected by the transition to ICD-10?
  6. Why are we moving to ICD-10?
  7. Can I just let my coder do it?
  8. Can I just use a mapping system such as GEMs?
  9. What will I need to include in my documentation?
  10. Questions?

Why does this need to happen?

After Oct. 1, 2015, hospitals that have not made the switch will not be able to receive federal reimbursement for services. This conversion is mission critical.

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How does ICD-10 improve patient care?

  • ICD-10 enhances the quality of patient care by providing a more dynamic data set to better measure patient outcomes and identify emerging disease trends.
  • ICD-10 also allows a more accurate way to identify public health threats, including infectious disease.
  • The transition to ICD-10 will improve accountability and safety within BMC by more accurately tracking adverse events and nosocomial infections.
  • ICD-9 is antiquated and doesn’t account for new procedures and other advances in health care technology that are identified in ICD-10.

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What’s expected of employees?

Employees impacted by ICD-10 will receive training specific to their role. Employees who are not directly impacted by ICD-10 should be supportive, enthusiastic and patient as we work together to ensure that care is not disrupted. We all have a role to play, and together we will be able to make a successful transition to ICD-10.

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How does this coincide with eMERGE, BMC’s new electronic health record system?

The ICD-10 project team and ITS Department are working on upgrading the impacted systems and ensuring an efficient integration between ICD-10 and eMERGE, BMC’s new electronic health record system.

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Who is affected by the transition to ICD-10?

Everyone covered by HIPAA must transition to ICD-10 by October 1, 2015. It is not limited to Medicare.

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Why are we moving to ICD-10?

ICD-10 is a more advanced and robust system than ICD-9, allowing for complex and detailed reporting that better fulfills the needs of health care today. The move to ICD-10 will increase the level of specificity available for research, public health, and other purposes.

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Can I just let my coder do it?

Yes. However, coders can only code what is given to them. ICD-10 is more robust and requires a significant amount of patient-specific information. If the documentation is not complete and does not provide the necessary information, the physician will be required to provide the coder with more details.

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Can I just use a mapping system such as GEMs?

Many mapping tools do not drill deep enough for the fourth through seventh digits. Also, because there is not always a one-to-one mapping between ICD-9 and ICD-10, mapping tools cannot always provide the definitive code for a given situation.

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What will I need to include in my documentation?

In general, you will need to include details such as laterality and ordinality. For specific conditions, requirements will vary; some examples for common conditions in family medicine include:

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  • Asthma: intermittent, mild persistent, moderate persistent, severe persistent
  • Fractures: Gustilo classification, type of fracture
  • Seizures: General or focal, type, intractability
  • Pregnancy: Which trimester
  • Poisoning or toxic effect: Which substance
  • Ulcers: Which stage

Questions?

Please contact: Pam Hansen, ICD-10 Program Director

Contact Us

Call: 617.414.0738
Email: Pamela.Hansen@bmc.org

Boston Medical Center
ICD-10 Program
BCD 2nd floor
830 Harrison Ave
Boston, MA 02118

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