ICD-10 - BCBSFL
ICD-10
Clinical Documentation Requirements
Presented by: Joe Nichols MD Date: Dec 20, 2013
Agenda
? Getting beyond resistance ? Business Impacts ? Why is good documentation important? ? Getting from assessment to documentation to the
right code
New definitions and guidelines that impact documentation and metrics
Medical concepts and patterns within codes "Unspecified" Codes
? Continuous quality improvement
2
The Challenge
Current Physician thinking on ICD-10
3
"There are too many Codes"
? There are lots of words in the dictionary, but that doesn't seem to trouble authors...
? 34,250 (50%) of all ICD-10CM codes are related to the musculoskeletal system
? 17,045 (25%) of all ICD-10CM codes are related to fractures
? ~25,000(36%) of all ICD-10-CM codes to distinguish `right' vs. `left'
? Only a very small percentage of the codes will be used most providers
4
Health Data Consulting ? 2013
Current Distribution of ICD-9 diagnosis codes
3 Years of Data - All claims - All lines of business - 1million Lives
Total Charges by Code
3years - $10 Bill
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0% 5% next ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5%
Charge %
5
Health Data Consulting ? 2010
Varying Code Volume
By Clinical Area
Clinical Area Fractures Poisoning and toxic effects Pregnancy related conditions Brain Injury Diabetes Migraine Bleeding disorders Mood related disorders Hypertensive Disease End stage renal disease Chronic respiratory failure
ICD-9 Codes 747 244 1104 292 69 40 26 78 33 11 7
6
Health Data Consulting ? 2013
ICD-10 Codes 17099 4662 2155 574 239 44 29 71 14 5 4
"Documentation for ICD-10 is an unnecessary burden."
? The number and type of new concepts required for ICD-10 are not foreign to clinicians
? The focus of documentation is good patient care ? Patients deserve to have accurate and complete
documentation of their conditions ? If other industries understand the value of accurate
and complete documentation of data about encounters and transactions; shouldn't we?
7
Health Data Consulting ? 2013
"ICD-10 won't help me take care of my patients."
? Difficult to make the case about how ICD-10 will help Dr. Smith with his encounter with Mary Jones
? Healthcare goes crosses the boundary of time, patients and providers
? Improving healthcare requires a broad understanding of what works and what doesn't work
? Clinicians should be leaders in the healthcare industry by providing accurate data, accurate analysis of the data and change in healthcare to continuously improve the value their patients receive
8
Health Data Consulting ? 2013
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