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The University of South Alabama Health System has successfully transitioned to an updated version of a health care classification system called the International Classification of Diseases (ICD).
Published by the World Health Organization, ICD is the standard diagnostic tool for epidemiology, health management and clinical purposes. It provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Under this system, every health condition and situation can be assigned to a unique category and assigned a code.
The ICD-9 code sets used to report medical diagnoses and inpatient procedures was replaced by the ICD-10 codes on Oct. 1, 2015.
The transition began in 2013 with Rebekah Bailey, director of compliance and reimbursement at USA; Sherryle Givens, RN, CPC, and manager of quality improvement at USA; and Kimberly Cannon, assistant director of reimbursement at USA; meeting regularly to create a plan of action for the implementation.
The overarching plan included electronic systems and vendor preparation, provider preparation and coder preparation. Documentation training modules for providers created by Givens were available on the HSF intranet. Electronic systems and vendors were inventoried for readiness, and intensive coder education was provided by Patricia Heck, RN, CPC; Deborah Wallace, RN, CPC; Barbara Burgess, RN, CPC; and Givens.
There was collaboration with the hospitals to ensure all aspects were covered across the health system, and surveys were sent to department chairs for provider input.
The final implementation plan included a refresher course for coders, training sessions for providers and staff, cross-walking the top ICD-9 codes for providers, updating billing sheets with ICD-10 codes, dual coding and onsite coder assistance. While the coding compliance nurse specialists were engaged in Physician Quality Reporting System (PQRS) reporting, Cannon was tasked with preparing all the training session materials, crosswalks and billing sheets.
“It was intense, but the basic ground work was laid out, and I had resources at my disposal through NextGen that made the task easier than it would have otherwise been,” Cannon said.
On October 1, 2015, coding staff was onsite in each of the clinics to assist the providers and clinical staff. The feedback was positive, and the resources that were provided were well received in all clinics.
“It is expected that with the increased documentation and specificity in coding, the acuity of care will be much more accurate,” Cannon said. “It takes the entire health system to implement and transition ICD-10. With the hard work that has been done by all involved in this process, we can’t help but succeed.”
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