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Hands On Help

10 ICD-10 Recommendations for HIM Professionals

Helping physicians prepare to transition to I-10.

LESLIE: As we get closer to the ICD-10 implementation deadline there have been several areas of focus, including coder education, progress on clinical documentation improvement initiatives and the impact of ICD-10 on revenue cycle.

PATTY: Fortunately there is a lot of help in each of these areas and the press is full of good advice and suggestions. I don't think anyone could say that there aren't enough resources across the country to help health systems and physician practices get ready.

LESLIE: CMS recently finished a round of end-to-end testing which provided evidence that the industry is well on its way to being ready by October 1, 2015. CMS processed Approximately 15,000 test claims recently which were submitted by 661 providers and billing companies. The testing acceptance rate was 81%, with 19% of claims rejected due to invalid codes and errors such as incorrect national provider identifiers, insurance claim numbers, and submitter IDs.

10 ICD-10 Recommendations for HIM ProfessionalsPATTY: Pretty good results, I think! End-to-End testing is a critical part of assessing readiness and it's great that this opportunity is being offered to providers. Testing helps identify problematic areas so they can be addressed sooner rather than later. CMS reports that no major issues have been observed during the course of testing.

LESLIE: In the spirit of reducing anxiety around I-10 implementation, physician practices have a safe opportunity to experience the impact of I-10 on their practice by implementing dual coding and taking advantage of testing opportunities. Engaging their staff and billing company in the process now will save a lot of headaches come October.

PATTY. I definitely think it's important to take advantage of upcoming testing opportunities as well as the education provided by CMS and others. The Road to I-10 tool, provided by CMS for example, is very helpful especially to smaller practices that have less implementation resources. Resources from CMS can be found on their website at

LESLIE: I really like the free CMS resource Road to10: The Small Physician Practice's Route to ICD-10 action plan. It's an interactive tool that will help any size practice and specialty build an action plan. It's very easy to use and presents information in a clear and helpful way.

PATTY: With CMS appearing to be ready for I-10, testimony on the importance of I-10 successfully behind us, and members of congress verbally backing I10, it does appear that that I-10 will be a reality this year.

LESLIE: I think the healthcare industry will move forward with greater confidence when congress has addressed the sustainable growth rate (SGR) Medicare payment formula. A twelve month SGR patch effective April 1 2014, which included the delay of I-10 implementation to October 1, 2015, will be expiring soon.  

PATTY: The Energy and Commerce Committee's Subcommittee on Health have communicated their support for not delaying ICD-10. During the subcommittee's hearings held on February 11, 2015, Rep. Kathy Castor (D-FL), strongly urged for no further delays and asked congressional leadership to "not include delays in must-pass bills, especially something as important as how we pay doctors." Her comment referred to the SGR patch.  

LESLIE: That is terrific! Kudo's to the Florida Health Information Management Association for rallying in Florida. I think Rep. Kathy Castor heard them rally on the twitter thread #ICDMatters and through their advocacy efforts.

PATTY: Speaking of #ICD10Matters, what a great source of information and what a strong I-10 Twitter community. It's been a great rallying space to put out facts and generate more urgency to transition to I10 in 2015.

LESLIE: So let's talk about how HIM professionals can best help physician practices prepare for this transition.

PATTY: The research study "Physicians' Outlook on the ICD-10-CM/PCS System and its Effect on their Practice." provides insights on what HIM professionals can do today to help physicians successfully transition to I10. The study, conducted by Care Communications, Inc.'s, CAREinnoLab and the Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh, includes the following 10 recommendations for HIM professionals:  

  1. Provide, by specialty, I-9, DSM and I-10 crosswalks to be used as a guide for the most common diagnoses.
  2. Provide training on how to document structured and unstructured text.
  3. Be positive rather than fear based when training physicians.
  4. Create a top ten code list by specialty -- "ICD10 dummies guide."
  5. Summarize the top 10 reasons claims are being rejected and help implement improvements.
  6. Educate coders and billers on how to maximize reimbursement.
  7. Be an expert resource and share your knowledge to help put into practice the right systems.
  8. Provide training in a way that engages physicians.
  9. Provide information on how I10 impacts patients' insurance.
  10. Provide assistance in setting up patient registries to better mine data for quality of care and outcomes.

LESLIE: The findings of this research study highlight the importance of creating simple and clear specialty guides and crosswalks as well as delivering engaging and positive educational experiences. The research study details can be accessed via AHIMA's online research journal Perspectives in Health Information Management.

PATTY: Providing I-10 transition leadership is an HIM professional responsibility and one we should all rally around. Our job is to make the I-10 implementation as painless and as seamless as possible for physicians and to support them as they redirect their energies to practicing medicine and spending time with their patients. #ICD10Matters!

Leslie Ann Fox is chief executive officer and Patty Thierry Sheridan is president, Care Communications Inc., Chicago. You can follow Leslie and Patty on their Twitter accounts, @FoxatCARE, and @pattytsheridan. Leslie and Patty invite readers to send their thoughts and opinions on this column to or

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IMHO there one additional way to prepare, which was not emphasized in this interesting article: the numerous apps out there that can help the small practices with the October 1st transition. One such app we have recently released can be found at:

Try it for free and please let us know your feedback


Dan TorenMarch 24, 2015


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