The Centers for Disease Control and Prevention (CDC) recently published its ICD-10-CM code changes for the fiscal year 2019 that take effect Oct. 1, 2018, and run through Sept. 30, 2019. In this annual update, there are 473 code changes, including 279 new codes, 143 revised codes and 51 de-activated codes. Additionally, 39 other changes were made from the proposed rule.
For example, there are new codes and other changes in Chapter 2: Neoplasm, as well as several new codes in Chapter 7: Diseases of the eye and adnexa. New codes were also added in Chapter 19: Injury, poisoning and certain other consequences of external causes.
Even with these changes, the volume is slowing down each subsequent year -- since the transition to ICD-10 three years ago, said Cathie Wilde, MRA’s director of coding. “It’s always different every year, but the changes have become more manageable as we come further away from the transition to ICD-10,” Wilde said.
However, education of coding teams and individual coders remains of utmost importance during these continual times of change, she said. Even now, during slower periods of changes in the world of coding, health systems much remain vigilant in their preparation of those changes. Education is the key especially for multi-facility and multi-geographic health systems, she said; for example, those that straddle state lines like Massachusetts and Connecticut. These organizations face a dual responsibility in maintaining the quality of their coding efforts and ensuring their practices meet the appropriate regulations for each district and municipality.
While this may seem obvious, not all healthcare leaders in these situations remain aware of the consequences or the necessary requirements placed upon their organizations. “Coding is anything but consistent,” Wilde said, in response to the vast swings in areas of focus that can take place from year to year and from locale to locale. “The most of the trouble hospitals face when coding is seeking clarification of codes and getting insight into how they might best manage the tweaks.”
Wilde said MRA provides regular educational opportunities to members of its coding team. Education modalities might include the use of electronic record disbursement, monthly meetings and regular updates via a remotely accessible portal that is designed to push out the most current and relevant coding updates and alerts.
“In many cases, healthcare organizational leaders don’t realize the extent of education people go through for coding,” she said. “In additional to becoming educated in anatomy and psychology, our team members must understand the medical condition a patient is undergoing. We really do have that expertise, and we must really be adept in numerous clinical aspects to remain a part of our coding teams.”
As coding becomes more important to hospitals as part of their reimbursement model, coding, in general, continues to increase in its professionalism and organization’s respect for the coder and coding team grows. Educational support for the coder and how they can better serve the facility is an obvious necessity brought about by such things as the annual coding changes proposed by the likes of the CDC. While the coding changes are becoming more manageable, regular preparation and response to these changes is a best practice of MRA.
Wilde also said that more resources to support coding and clinical documentation can mean an improvement in physician coding practices, but the two are not mutually exclusive. What’s most important for quality coding is staying up to date regarding changes, bringing in support when needed to meet coding challenges and providing regular education to members of the coding team - via an outside vendor resource or internally - so coding teams maintain the highest professional standards and meet necessary requirements of the health system.
For more information about the current coding changes and guidelines, feel free to visit the CMS.gov dedicated page or contact MRA for assistance.
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