Ten principles to help you engage providers around ICD-10

Tom Darr, MDWith less than three months until the ICD-10 go-live date, you may still be having trouble engaging providers around the new code set. If so, that’s not surprising. While we know that patient care will ultimately benefit from ICD-10’s increased specificity and data detail, doctors are focused on the here and now. And frankly, they don’t pay much heed to the “health care industry.” They’re concerned about their patients and their practices.

As a practicing ER physician and an informaticist, I understand both perspectives. So, in the interest of helping both physicians and HIM professionals be successful under ICD-10, I offer the following 10 principles to help HIM pros engage physicians:

  1. Stop trying to convince providers that ICD-10 is a good idea. Focus on the real issue, which is, how do we make this work for you and how do we take a practical approach?
  2. Focus on the root cause for the change to ICD-10. Let’s remember that, with all of ICD-10’s benefits, we’re replacing ICD-9 because it’s outdated, not because the data will be better or because we need to catch up with the rest of the world. A change was required.
  3. Talk about specifics that affect providers, not generalities that are irrelevant. ICD-10 will improve the ability to report on risk of mortality, severity of illness, present on admission, patient safety indicators, meaningful use, medical necessity, core measures and comparative effectiveness research. These are issues that affect, either directly or indirectly, a physician’s reimbursement.
  4. Focus on the patient and the documentation, not on the classification system. I think it’s safe to say that for virtually every doctor in America, their patients won’t change when ICD-10 becomes the law of land.
  5. Change physician perspective to one that makes sense to them. ICD-10 is not full of concepts that are foreign to physicians. It is all about classifying and billing for the care they provide for the diseases they see day in and day out.
  6. Bust a few myths. Yes, there are 68,000 ICD-10 diagnosis codes, but an analysis of Optum360 data shows — and providers confirm — that 25 (or fewer) codes constitute a vast majority of a single provider’s work. That means physicians can literally throw out 99.9% of the ICD-10 diagnosis codes.
  7. Provide a practical approach to preparing for ICD-10. Start with the codes you work with on a daily basis and set aside the ones that will stay the same. For the codes that will change, check an ICD-10 reference source to see whether your current documentation already satisfies the requirements for the code. For the codes that will have to change, decide how to adjust your documentation.
  8. Organize your toolbox. Address the tools you have to work with for documentation, once you know where you actually need to adjust, including templates, diagnosis pick lists, super bills, etc.
  9. It’s the documentation, stupid. Understand that the real issue with documentation is poor documentation to begin with, not ICD-10 requiring additional information. So, address your documentation issues.
  10. Start now.

Learn more about ICD-10 physician training

Optum360 physician training offers a foundational understanding of ICD-10, how it affects physicians, and what the major impacts will be to their documentation requirements. Learn more at our ICD-10 Training web site and also visit our ICD-10 information web site.


About the Author

Tom Darr, MD
Chief Medical Officer

As chief medical officer, Tom Darr, MD, brings a patient focus to Optum360 technology solutions and services. He is a practicing emergency medicine physician and certified by the American Board of Emergency Medicine.

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