August 2015

August 2015

Your software company won't be taking care of everything. What your software gives you is simply the ICD-10 codes themselves. And while essential, a list of the new codes on your computer isn't going to help you understand what those codes mean in relation to their ICD-9 counterparts. Or how to correctly use them.

Compared to ICD-10, ICD-9 is a pretty primitive language. It allowed you to tell an insurer that a patient's shoulder was dislocated, but not which shoulder, or how the injury occurred. So a single ICD-9 code could translate into as many as four different ICD-10 codes. Will you know which one to use?

Your expensive software will be of little help.

What you need is a good mapping tool: a resource that crosswalks any given ICD-9 code to their several ICD-10 equivalents. (CMS has developed a GEM—General Equivalency Mapping tool—available on the ACA website.) You also need the anatomical knowledge, coding training, and clinical expertise to understand how to choose the ICD-10 code that most clearly describes your patient's condition and, therefore, is most likely to get you reimbursed.

Your software company are good people who are well-intentioned and providing what they can. But they can’t help you become fluent in ICD-10 any more than they can teach you Portuguese. (Você fala Português agora?)

Do yourself a favor. Get help, and get started on what is a rather steep learning curve. Find out what we offer at KMC University. Because come October 1st, you're the one who needs to be fluent in ICD-10—not your computer software.