If you haven't heard the news about the important correlation between ICD-10 and anatomy and pathophysiology, then it's time we start that conversation. As the healthcare industry gears up for the transition to ICD-10, the necessity of acquiring and fine-tuning this knowledge base will be key to the transition's success, particularly from the coding standpoint. A&P will be to ICD-10 coding what concrete is to a building's foundation, what mortar is to a brick wall, what flour is to a cookie recipe.  

True, you could theoretically leave out these "key" ingredients, but where will it leave you in the end? Would your building be able to stand, would your brick wall be a protection, would anyone enjoy eating your cookies?  Now that we've established that visual in your cranium, let's take a look at what the return on our investment will be as we embrace the task before us and become a student again.

Gearing Up for Change

ICD-10 is the catalyst for a variety of changes. Change is never easy to embrace, even when the outcome will be an improvement. The only one who welcomes a change, is a wet baby. 

Essentially, there are two reasons for change: 

1. Our current circumstance or methods become so painful, that we have to change, or

2. We find a better way to accomplish a task or goal, and we actually want to change. 

ICD-10 meets both of these "change" criteria. Our current coding system is no longer functional and will not allow us adequate expansion to report the ever evolving conditions and treatments necessary for healthcare.

Secondly, once we see the benefits of ICD-10, we will actually desire that change to occur.  For now, we can only look strategically at what we anticipate those changes will be.  Because of the nature of ICD-10's ability for capturing and reporting diagnoses with greater specificity, it stands to reason that those individuals who will be reading documentation and assigning appropriate codes will need to have sharpened skills to effectively capture the right information.  Identifying the anticipated needs - specifically anatomy, physiology and pathophysiology - and having the wisdom to prepare early and then engage in those pursuits can be an exciting journey. How can anatomy, physiology and pathophysiology (A, P & P) be an exciting journey, you ask? 

Understanding A, P & P

Consider for a moment, the simple act of waking up in the morning. Through the night your normal cardiovascular and respiratory systems are functioning without you even thinking about it. Your mind dreams, your musculoskeletal system may engage as you shift in your sleep. Then your audiovisual systems leap into action as the alarm rings, and you look to see what time it is. You may, at this point, engage your musculoskeletal system to strike the "snooze" button for a little more time to remain in your temporary state of euphoria. All of this takes place before you even get out of bed to start the activities of your day. Learning about how all of these systems function and work together is truly an amazing journey. 

Once we understand the basics of A&P, it's then important to gain an understanding of how diseases affect the normal healthy functions of these phenomenal organ and body systems by studying pathophysiology. You may ask the question: Aren't physiology and pathophysiology one in the same? The answer is no. Anatomy is defined as the study of normal body structures. Physiology is the study of normal, healthy bodily functions, and pathophysiology is the study of the changes of normal mechanical, physical, and biochemical functions, either caused by a disease, or resulting from an abnormal syndrome.

A coder who is well-versed on how an organ system functions, in both the healthy state as well as during the disease processes, will be better equipped to intelligently query providers when additional documentation is required.  Conversely, a coder who has in depth understanding of A, P & P will be able to make appropriate correlations when reviewing documentation and avoid needlessly approaching providers for clarification.  

Starting the Journey

If this isn't enough reason to start the journey to greater understanding of A, P & P, consider this:  It has been my experience that many students, upon completion of the A, P & P courses, begin to understand the importance of developing and maintaining healthy habits, as well as abandoning unhealthy ones. They recognize the delicate intricacies in place and the habits that need to be practiced to lead healthy lives.  

Another added benefit of increasing our knowledge of these crucial subjects is that as we begin to learn and understand how marvelously our body structures and organ systems work together, one can't help but develop a deep respect for the human body. This is something that we all have in common - we are all living in these incredible bodies that allow us to experience life. It really is an amazing journey that you will want to take! 

Marilyn Holley earned her degree in health information management from Weber State University in 1992. She was a coding/data/medical records manager for a multispecialty clinic in Ogden, Utah, and has more than 15 years of experience in ED provider/facility coding. She has also been an AAPC workshop presenter on diverse coding and practice management topics over the last five years.

Coding Corner is provided by AAPC, a training and credentialing organization for the business side of medicine.