Discussion of ICD-10 Will Open AHIMA’s LTPAC Health IT Summit

Long-term and post-acute care (LTPAC) providers—unlike much of AHIMA’s membership—welcomed the delay of ICD-10-CM this spring, according AHIMA LTPAC Summit presenter Mary Ann P. Leonard, RHIA, CRM, RAC-CT. Leonard’s session, which opens the Summit, will attempt to respond to ongoing concerns about the code set from LTPAC providers.

“Long-term care has a history of making changes only when they have to,” Leonard explains. “They don’t usually prepare too far ahead for anything. If it isn’t mandated and/or identified in survey (planned and unplanned inspections by state regulators) it isn’t a priority. Part of that is the flat hierarchy—there aren’t a lot of knowledgeable management heads or hands to do the work. Part of it is financial.”

Leonard’s presentation, “Preparing LTPAC for ICD-10-CM: Technology, Documentation, Workforce and Pysician Engagement,” will be Sunday, June 22, at 3:30 p.m. ET, in Baltimore, at AHIMA’s 10th Annual LTPAC Health IT Summit. She will be joined by two co-presenters: Nick Dobrzelecki, RN, BSN, of The Corridor Group, and Jeanne Doherty, MD, Magee Rehabilitation Hospital.

Leonard says her session is principally an overview of the ICD-10-CM coding system and differences between ICD-10 and ICD-9.

“In addition it [the presentation] provides questions for the administrator to ask the vendor, management, etc. to assist in preparing for the implementation process,” Leonard says. “Most of the questions actually came from the materials on the CMS ICD-10-CM website. [LTPAC facility] administrators usually will ask the vendor if they will be ready and take them (and others) at their word that they will be. They don’t ask the additional questions, such as, ‘Can we dual code? When can we dual code? How long will ICD-9 stay in the system, etc.’”

Overall, ICD-9 and ICD-10 coding in LTPAC settings is less complicated than in hospital, physician, and ambulatory clinics because nursing home and rehab facility residents more often have the same diagnoses, such as chronic obstructive pulmonary disorder, chronic heart failure, hip fractures, and so forth.

For LTPAC, Leonard says the difficulty with implementing and using ICD-10 is “how to access the codes and interpreting which is the appropriate code to assign,” not the sheer number of new codes to learn.

“I can guarantee that once they latch on to a code that is close and goes through the system it will be used over and over. I suspect that there will be a lot of non-specific codes from LTC [long term care providers],” she adds.


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