Documentation, Delay Impacts, Stubborn Physicians Top Summit Topics

The proposed ICD-10 delay and how it impacts industry preparation plans was one of several hot topics permeating two days of sessions, April 16-17, at AHIMA’s 2012 ICD-10 Summit in Baltimore. This concern was reiterated Tuesday during the final session of the Summit, “Reflections of the 2012 ICD-10 Summit Reactor Panel,” where presenters and subject matter expert attendees recapped their main takeaways from the event.

One main point: many attendees were on track to meet the October 1, 2013, deadline and are against any delay of ICD-10. The audience cheered when panel member Dr. Jeff Linzer, with the American Academy of Pediatrics, frankly stated a delay is not necessary and the industry needs to stand behind the original deadline.

“We have known about this since 2009, with the proposed rule in 2008. The industry has put a lot of money into the 2013 deadline. If you are not ready, then shame on you,” Linzer said.

Panelist Maria Bounos, RN, MPM, CPC-H, business development manager with consulting firm Wolters Kluwer, agreed by saying that the delay of ICD-10 hurts the hard work done implementing the code set.

“I think it is a shame they went ahead with the delay because now no one is going to take CMS seriously,” she said.

Panelist Melody Mulaik, MSHS, CPC, RCC, with the Healthcare Billing and Management Association, said that regardless of the final delay timeline, CMS needs to conduct some damage control and reiterate it means business on ICD-10.

“I want to get them to promise that this is it, and we will see a hard and fast date,” Mulaik said.

If ICD-10 is delayed, the industry should make the most of it and further their testing of the system, another hot topic of discussion. Whether they believed a delay was necessary or not, all presenters agreed organizations should treat it as an opportunity for ICD-10 improvement.

A delay should be leveraged by industry groups regardless of their current implementation status, said Juliet Santos, a panelist with the Healthcare Information and Management Systems Society (HIMSS). A recent HIMSS event brought together a diverse group of stakeholders to discuss the potential for those ICD-10 adopters currently on track to take part in an ICD-10 implementation pilot program. The pilot would allow leaders in ICD-10 adoption to use the delay to officially test ICD-10 “end to end, and nationwide” with other industry representatives, which would prevent a backslide of resources and effort, Santos said. At the same time, the launch and results of this pilot could be used to prod hesitant late adopters as well as emphasize that ICD-10 will indeed be implemented. HIMSS plans to release a preliminary report calling for this pilot in July 2012.

CMS’ Denise Buenning said earlier at the Summit that a pilot testing idea is being entertained by CMS, though they currently do not have the funding or official plans to implement it.

All Summit presenters emphasized that a potential ICD-10 delay is no reason to stop implementation efforts, a call echoed by the panel.

“Don’t slow down, and if you haven’t started, start now” was a rallying cry heard throughout the Summit, according to Faith C. M. McNicholas, CPC, CPCD, PCS, CDC , manager, coding and reimbursement/government affairs, at the American Academy of Dermatology, who moderated the panel.

Another theme of the Summit was the issue of improving documentation to support more specific ICD-10 codes—specifically improving physician documentation. Convincing some physicians that ICD-10 is worth implementing was also a hot topic. Many of the standing-room only Summit sessions centered on improving physician documentation.

Linzer asserted that poor physician documentation starts in academia. The industry needs to teach good documentation skills early in a physician’s education for this issue to be resolved.

“You need to get good habits into the students, the resident programs, and teach them how to write a note. It is not cutting and pasting,” Linzer said. “It doesn’t matter if it is ICD-9 or ICD-10, bad documentation is bad documentation.”

Physicians also need to be educated on the benefits of ICD-10. Currently it is seen as an administrative burden, the panelists said, and that needs to change if ICD-10 is going to be successful.

“Over 95 percent of diagnosis codes come from physicians,” Linzer pointed out. “Physicians need to learn the purpose of ICD.”

For those behind on their implementation, now is the time to jump on the ICD-10 bandwagon, Bounos said. Also, no one should delay voicing their opinion on a delay.

“Whether or not the delay is great or detrimental for you, CMS should know and wants to know,” Bounos said.

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