With 10,000 baby boomers turning 65 every day, the need for qualified and well-trained workers in the medical fields is stronger than ever.
As private practices and other medical facilities prepare for new medical coding protocols, the industry is busy retraining personnel and readying computer systems.
Documentation is at the core of all health care. It must be precise, complete, and accurate to describe the care and services performed. Clinical documentation ensures providers are reimbursed and that reporting is accurate. Documentation codes like ICD-10 and the expiring ICD-9 are used to report diagnoses and inpatient procedures.
Why the switch? ICD-9 produces limited documentation about patients’ medical conditions and hospital inpatient procedures. The code is 30 years old and uses terminology that isn’t part of modern medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and some ICD-9 categories are full.
The switch to ICD-10 does not affect CPT coding for outpatient procedures; the codes are for hospital inpatient procedures only. Everyone covered by HIPAA must make the switch. Like ICD-9 codes, ICD-10 will be updated annually. The ICD-10 kick-off date is Oct. 1, 2014 (Is ICD-10 Postponement Prolonging the Pain?).
The transition to ICD-10 is changing health information management (HIM). Changes include how employees are trained and how electronic health records (EHR) are managed. These changes come at the same time as the sea change brought by the Patient Protection and Affordable Care Act (PPACA).
In preparation for full ICD-10 compliance, many health providers are farming out such functions as coding, transcription, scanning, and releasing of information. Others are looking into computer-assisted coding and clinical documentation improvement technology.
Technology can’t replace human skills, at least not completely. Many professional coders are retiring early rather than learning the new, more complicated set of diagnostic codes. This means there will be lots of potential job openings for coders and transcriptionists just getting started in the field.
Coders who get certified in ICD-10 (which stands for the International Statistical Classification of Diseases and Related Health Problems, 10th Revision and is mandated by the Centers for Medicare and Medicaid Services) are becoming a very hot commodity. Certification means they can work with the 68,000 new diagnostic codes, which is about five times the number they worked with ICD-9.
If you work for a medical organization implementing ICD-10, be sure to assess your system readiness by determining how compatible your EHR system is. Invest in training and communication. Seek third-party support if expert consultation can ease the transition. The best advice seems to be to not delay—preparing today will make Oct. 1, 2014 a lot easier.
For their part, coders are focusing on medical terminology, pharmacology, anatomy and physiology training to learn the new requirements. Clinicians and administrators also have a steep learning curve. Some are nervous and apprehensive about the changes. But in the long run, the level of specificity the new coding systems bring will be a good thing for providers and for patients. But getting over the training hurdle will continue to be a challenge that affects almost every facet of the industry, from clinical to IT, from data and reporting to human resources.