ICD-10: An Area We Call. Presented by Harry Goldsmith, DPM
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1 ICD-10: An Area We Call Presented by Harry Goldsmith, DPM
2 ICD-10 Presented by Harry Goldsmith, DPM
3 Sponsored by
4 Disclaimer This portion of tonight s presentation is brought to you by Harry Goldsmith, DPM who is solely responsible for its content and delivery so don t complain to or blame PICA about any demonstrated insensitivity, poor judgment, unfunny jokes, puns that aren t punny, or lack of taste
5 October 1, 2015 ICD-10: Count on it!
6 October 1, 2015 ICD-10 delays have negatively impacted ICD-10 readiness because many in the healthcare industry still believe there will another delay on the horizon.
7 Are You Ready for ICD-10?
8 ICD-10 There is nothing exceptionally difficult about ICD-10, if you bother to prepare.
9 October 1, 2015 ICD-10: Count on it!
10 Our Discussion Tonight ICD-10 Preparation Timeline Workflow, Productivity, and Glitches ICD-10 & Diabetes Coding Practice
11 Our Discussion Tonight ICD-10 Preparation Timeline Workflow, Productivity, and Glitches ICD-10 & Diabetes Coding 7 th Character: Sequela Practice
12 ICD-10 Preparation Timeline
13 ICD-10 Preparation Timeline Things that should have already been done: Designate an office ICD-10 project manager Contact vendors, clearinghouses, payers Convert your top ICD-9 codes to ICD-10
14 ICD-10 Preparation Timeline Things that should have already been done: Designate an office ICD-10 project manager Contact vendors, clearinghouses, payers Convert your top ICD-9 codes to ICD-10
15 ICD-10 Preparation Timeline Things that should have already been done: Designate an office ICD-10 project manager Contact vendors, clearinghouses, payers Convert your top ICD-9 codes to ICD-10
16 ICD-10 Preparation Timeline Things that need (ongoing) to be done: Review ICD-10 guidelines Arrange for a line of credit Practice
17 ICD-10 Preparation Timeline Things that need (ongoing) to be done: Review the guidelines and conventions Arrange for a line of credit Practice
18 ICD-10 Preparation Timeline Things that need (ongoing) to be done: Review the guidelines and conventions Arrange for a line of credit Practice
19 Ow!!! I Stubbed Toe Mr. Peterson states he got up in the middle of the night to go to the bathroom when he hit his toe on the door jam. The right little toe is swollen, reddish, and painful. The nail appears intact. Impression: contusion, 5 th right toe What s the main term?
20 Ow!!! I Stubbed Toe Mr. Peterson states he got up in the middle of the night to go to the bathroom when he hit his toe on the door jam. The right little toe is swollen, reddish, and painful. The nail appears intact. Impression: contusion, 5 th right toe What s the main term?
21 Contusion, 5 th Right Toe
22 Contusion, 5 th Right Toe
23 Contusion, 5 th Right Toe
24 Contusion, 5 th Right Toe
25 Contusion, 5 th Right Toe
26 Contusion, 5 th Right Toe S90.12-
27 Contusion, 5 th Right Toe S90.12-
28 With a Click Go to the Tabular List S90.12
29 Contusion, 5 th Right Toe S90.12-
30 Contusion, 5 th Right Toe S90.121
31 Contusion, 5 th Right Toe S90.121_
32 Contusion, 5 th Right Toe
33 Contusion, 5 th Right Toe S90.121_
34 Contusion, 5 th Right Toe S90.121_
35 Contusion, 5 th Right Toe S90.121_
36 Contusion, 5 th Right Toe S90.121A
37 Tada
38
39 Contusion, 5 th Right Toe
40 Contusion, 5 th Right Toe
41 Contusion, 5 th Right Toe
42 Contusion, 5 th Right Toe
43 With a Click Go to the Tabular List S90-
44 Contusion, 5 th Right Toe
45 Contusion, 5 th Right Toe
46 Contusion, 5 th Right Toe
47 Contusion, 5 th Right Toe S90.121_
48 Contusion, 5 th Right Toe S90.121_
49 Contusion, 5 th Right Toe S90.121A
50 Tada
51
52 Contusion, 5 th Right Toe
53 Contusion, 5 th Right Toe
54 Contusion, 5 th Right Toe
55 Contusion, 5 th Right Toe
56 Contusion, 5 th Right Toe
57 Contusion, 5 th Right Toe
58 Contusion, 5 th Right Toe
59 Contusion, 5 th Right Toe
60 Contusion, 5 th Right Toe
61 Tada
62 APMA Coding Resource Center
63 ICD-10 Shortcuts
64 ICD-10 Coding It s not really difficult
65 Workflow-Productivity
66 Workflow-Productivity Reality Check The hardest thing about ICD-10 is going to be trying to minimize its negative impact on your productivity
67 Workflow-Productivity O Canada! Transitioned to ICD-10-CA ( ) Has 17,000 diagnostic and procedure codes ICD-10-CA codes are 3-6 characters in length And how did that work out for you, Canada, eh?
68 Workflow-Productivity O Canada! AHIMA & AHA study found professional coders productivity 1 year post transition was only 81% with hospital chart coding 79% for day surgery coding, and 85% for emergency department chart coding
69 How are you planning on getting a completed ICD- 10 version of this to your front office and to your biller?
70 Workflow-Productivity Rely on your EHR and office software to provide you a solution? Modify your paper superbill to allow you to communicate additional information to the biller? Create cheat sheets? Hire additional staffing?
71 Workflow-Productivity Issues
72 ICD-10 Diabetes Coding
73 ICD-10 Diabetes Coding Diabetes codes are found in the E chapter Controlled/uncontrolled status is not a coding factor in ICD-10 Diabetes subcategory coding includes combination codes and instructions
74 ICD-10 Diabetes Coding Diabetes codes are grouped into 5 categories: E08- Diabetes due to an underlying condition E09- Diabetes induced by a drug or chemical E10- Diabetes, Type 1 E11- Diabetes, Type 2 E13- Diabetes, other specified
75 ICD-10 Diabetes Coding Diabetes codes are grouped into 5 categories: E08- Diabetes due to an underlying condition E09- Diabetes induced by a drug or chemical E10- Diabetes, Type 1 E11- Diabetes, Type 2 E13- Diabetes, other specified
76 Diabetes: Type 1 (E10-)
77 Diabetes: Type 1 (E10-)
78 Diabetes: Type 1 (E10-)
79 Combination Codes
80 Instructions
81 Instructions
82 Diabetes: Type 2 (E11-)
83 How About a Coding Example?
84 Coding Routine Foot Care
85 Routine Foot Care Chief Complaint: Need my nails trimmed. History of Present Illness: Patient, type II, diabetic with good control. She has 0/4 dorsalis pedis pulses bilateral; +2/4 posterior tibial pulse right; 0/4 posterior tibial pulse left. Her skin exam notes decreased hair bilaterally, long thickened yellow nails, and atrophic (thinning) of skin. There is a corn dorsal 5 th right; IPK subtibial sesamoid left. She has mild bilateral swelling in the ankles. Neuro: unremarkable. The patient has no reported complaints at this time. She has returned for her regular nail care.
86 Routine Foot Care Pertinent Information No pulses on the left foot; +2/4 posterior tibial pulse right foot Long thicken yellow nails Corn dorsal 5 th right Callus subtibial sesamoid left.
87 Routine Foot Care Diagnoses Diabetes, type 2 Peripheral vascular disease Mycotic nails Corn, dorsal 5 th right Callus subtibial sesamoid left
88 Routine Foot Care Diagnoses Diabetes, type 2 Peripheral vascular disease Mycotic nails Corn, dorsal 5 th right Callus subtibial sesamoid left
89 Diabetes, Type 2, PVD
90 Diabetes, Type 2, PVD
91 Diabetes, Type 2, PVD
92 Diabetes, Type 2, PVD
93 Diabetes, Type 2, PVD
94 Routine Foot Care Diagnoses 1. E11.51 (diabetes, type 2, with peripheral vascular disease) 2. Mycotic nails 3. Corn, dorsal 5 th right 4. Callus subtibial sesamoid left
95 Routine Foot Care Diagnoses 1. E11.51 (diabetes, type 2, with peripheral vascular disease) 2. Mycotic nails 3. Corn, dorsal 5 th right 4. Callus subtibial sesamoid left
96 Mycotic Nails
97 Mycotic Nails
98 Mycotic Nails
99 Mycotic Nails
100 Routine Foot Care Diagnoses 1. E11.51 (diabetes, type 2, with peripheral vascular disease) 2. B35.1 (mycotic nail) 3. Corn, dorsal 5 th right 4. Callus subtibial sesamoid left
101 Routine Foot Care Diagnoses 1. E11.51 (diabetes, type 2, with peripheral vascular disease) 2. B35.1 (mycotic nail) 3. Corn, dorsal 5 th right 4. Callus subtibial sesamoid left
102 Corn, 5 th Right Toe
103 Corn, 5 th Right Toe
104 Corn, 5 th Right Toe
105 Corn, 5 th Right Toe
106 Routine Foot Care Diagnoses 1. E11.51 (diabetes, type 2, with peripheral vascular disease) 2. B35.1 (mycotic nail) 3. L84 (corn) 4. Callus subtibial sesamoid left
107 Routine Foot Care Diagnoses 1. E11.51 (diabetes, type 2, with peripheral vascular disease) 2. B35.1 (mycotic nail) 3. L84 (corn) 4. Callus subtibial sesamoid left
108 Callus, Left Foot
109 Routine Foot Care Diagnoses 1. E11.51 (diabetes, type 2, with peripheral vascular disease) 2. B35.1 (mycotic nail) 3. L84 (corn/callus) 4. L84 (callus)
110 Routine Foot Care Diagnoses 1. E11.51 (diabetes, type 2, with peripheral vascular disease) 2. B35.1 (mycotic nail) 3. L84 (corn/callus) 4. L84 (callus)
111 Routine Foot Care Diagnoses 1. E11.51 (diabetes, type 2, with peripheral vascular disease) 2. B35.1 (mycotic nail) 3. L84 (corn/callus)
112 Tada
113 What Have We Learned? You can t learn everything about ICD-10 in 20 minutes that s why this is a sampler ICD-10 is not difficult to understand or code ICD-10 will, however, negatively affect your practice workflow and efficiency unless you prepare ahead of time There are resources out there to help you
114 October 1, 2015 ICD-10: Count on it!
115 Thank you!
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Making the Transition: ICD-10-CM Diagnosis Codes ICD-10-CM: International Classification of Diseases, 10th Edition, Clinical Modification
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