Thursday, January 23, 2014

How ICD-10 Disproportionally Affects Some Specialties

The whole health care industry is worried about the transition to ICD-10 code sets, but perhaps some should be more concerned than others. According to new research published in the Journal of the American Medical Informatics Association (JAMIA), the ICD-10 changeover is likely to impact certain specialties more so than others.

The research, conducted by a team at the University of Chicago, suggested that mappings between ICD-9-CM and ICD-10-CM were more convoluted for some specialties than for others. Specifically, the researchers found that hematology and oncology were positioned for the easiest transition, while obstetrics, psychiatry and emergency medicine were facing the most challenges in the changeover.

The researchers found that nearly half of infectious disease code mappings (42 percent) and 27 percent of emergency room diagnoses remain convoluted, meaning that the ICD-9 codes and ICD-10 codes have complex and non-reciprocal mappings. Musculoskeletal, injury and poisoning clinical classes were also found to include a large number of difficult-to-translate codes. The researchers identified five mapping motif categories that indicate the way ICD-9 codes translate to ICD-10 codes. These five categories include: identity, class-to-subclass, subclass-to-class, convoluted and no mapping. According to the research, one percent of ICD-9 codes had no corresponding codes in ICD-10.

In addition to studying how the ICD-10 transition will impact various specialties, the researchers created an online portal clinicians can use to see how convoluted code conversion will be. This portal will be a helpful tool for clinicians to see how much their codes will change and the level of documentation that will be needed to support ICD-10 codes.

So what should you do if you are in one of these specialties facing a more difficult transition to ICD-10 codes? Start preparing as early as possible. Invest in staff training and focus on the most commonly used codes and most complex mappings. Be aware that the more complex the transition is for your specialty, the more financial impact the transition could have on your practice.


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