The Healthcare Information and Management Systems Society and Workgroup for Electron in Data Interchange recently released a report on ICD-10’s national pilot program. The results within this report found that only 63% of submitted ICD-10 codes were complete and precise. Although this finding occurred prior to the ICD-10 coding system being enforced on October 2015, it was still able to collect relevant errors and mistakes to avoid while moving forward with this system.
Undoubtedly, the factor causing the most common ICD-10 coding errors is with coders and physicians trying to learn the new system – which is basically a new language. ICD-9 was in place for over 30 years. During this time, healthcare coders and physicians – as you can imagine – became very familiar with the system and learned to use it quite efficiently. Now, so many years later, switching to a new coding system is obscure and is going to take time to become accustomed to. To help avoid these mistakes, we have pulled together the 3 most common errors coders encounter when submitting ICD-10 codes – and how to fix them, should they occur…
Error:Because the ICD-9 coding system was in place for many years, it became comfortable and routine; medical coders became very familiar with this system, which is now causing problems when using the ICD-10 coding system. Out of habit, a number of coders are still using ICD-9 codes, or are selecting the wrong ICD-10 code due to lack of knowledge, and the fact that there several more healthcare codes included in ICD-10.
Solution: Be patient and diligent in your learning. ICD-10 is a major transition and will take some time to become accustomed to. Stay well educated on the new coding system, pursue ICD-10 trainings, and know that over time this mistake will become less common. Double check, triple check, and be sure the proper codes are being used.
Error:ICD-10 brings with it new codes and sub-codes that are unfamiliar to medical coders. This wide range of new numbers and letters is causing coders to submit incomplete codes because they are forgetting to use the additional codes presented with ICD-10.
Solution: It’s more sufficient to you and your healthcare organization to code at a steady pace, utilizing books, guides, or trainings to help submit complete codes. Create guides or cheat sheets for various specialties to help keep you on your toes and using the correct, complete ICD-10 codes.
Error:Many coders are accidently confusing the number 0 for the uppercase letter O, and the number 1 for the lowercase letter l. This incorrect usage of numbers and letters within ICD-10 codes is causing rejected claims, denials, and a slew of claims that need to be resubmitted.
Solution: Be careful, and again – double and triple check when coding to look for small errors like these. This mistake occurs often and is a simple and avoidable error.
These mistakes, while not too complex, will take some time to learn from and avoid. As you’re becoming familiar with ICD-10, take time to research best practices to follow and become an expert of the ICD-10 coding system. ICD-10 Education and practice will take time, but pay off in the long run. There are several trainings and educational guides offered for those interested in learning more about ICD-10. Aside from becoming educated on the system, utilizing and submitting codes is the best way to learn. It is likely you are going to make a few mistakes along the way, but with mistakes comes learning opportunities.
If you find that ICD-10 is taking too much time and money from your organization, consider HIS as your solution. HIS can offer information, education, and outsourced management on your billing, coding, and revenue cycle managment. We are experienced, educated, and certified professionals ready to help maximize your organization’s reimbursements and profitability.