ICD-10 IN PRIMARY CARE - AAPC

ICD-10 IN PRIMARY CARE An Approach to Clinical

Documentation Improvement

LYNN M. MYERS MD, CPC, CHC

Agenda

? The Challenge of ICD-10 ? The Assessment of our Providers ? Actions Taken ? The Result

The Challenge

Train providers on ICD-1?

? Coding guidelines ? Documentation ? EMR upgrades ? Paper vs. electronic ? Hospital and ambulatory

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Defining the Scope

? Identify the high impact codes

? Unspecified code analysis

? Audit Charts for 5 specialties

? Cardiology ? Orthopedics ? Obstetrics ? Family Practice ? Internal Medicine

Code 401.9 244.9 268.9 477.9 285.9 461.9 465.9 724.5 789.00 493.9 584.9 486 174.9 280.9 715.90 733.90 682.9 692.9 473.9 382.9 443.9 716.90 402.9 274.9 585.9 162.9

Description HYPERTENSION NOS HYPOTHYROIDISM NOS VITAMIN D DEFICIENCY NOS ALLERGIC RHINITIS NOS ANEMIA NOS ACUTE SINUSITIS NOS ACUTE URI NOS BACKACHE NOS ABDOM PAIN NOS SITE ASTHMA, UNSPECIFIED ACUTE RENAL FAILURE NOS PNEUMONIA, ORGANISM NOS MALIGN NEOPL BREAST NOS IRON DEFIC ANEMIA NOS OSTEOARTHROS NOS-UNSPEC BONE & CARTILAGE DIS NOS CELLULITIS NOS DERMATITIS NOS CHRONIC SINUSITIS NOS OTITIS MEDIA NOS PERIPH VASCULAR DIS NOS ARTHROPATHY NOS-UNSPEC HYPERTENSIVE HRT DIS NOS GOUT NOS CHRONIC KIDNEY DISEASE NOS MAL NEO BRONCH/LUNG NOS

Count 72652 68916 47850 30912 29669 22670 20344 14365 12788 12965 10363 10102 9596 9096 7734 7051 6765 6859 5774 5921 5841 4621 4526 4339 4263 4438

% Total

13.85% 11.61% 10.59%

7.65% 7.95% 6.60% 6.34% 4.78% 4.47% 4.75% 3.98% 4.04% 4.00% 3.95% 3.50% 3.30% 3.28% 3.44% 3.00% 3.17% 3.23% 2.64% 2.65% 2.61% 2.64% 2.82%

Audit Report

.

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ICD-9-10 Diagnosis Accuracy

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

Orthopedics Obstetrics Internal Med

Family Practice

Cardiology

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ICD10 ICD9

8

ICD9 vs. ICD10 Cardiology

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

Provider 1 Provider 2 Provider 3 Provider 4 Provider 5

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ICD10 ICD9

9

3

77% 76% 75% 74% 73% 72% 71% 70%

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Summary Cardiology

Cardiology

ICD10 ICD9

10

ICD9 vs. ICD10 Family Practice

90% 80% 70% 60% 50% 40% 30% 20% 10%

0% Provider 1 Provider 2 Provider 3 Provider 4 Provider 5

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ICD10 ICD9

11

Summary Family Practice

80% 70% 60% 50% 40% 30% 20% 10%

0%

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Family Practice

ICD10 ICD9

12

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ICD9 vs. ICD10 Internal Medicine (not including hospitalists or LTAC)

90% 80% 70% 60% 50% 40% 30% 20% 10%

0% Provider 1 Provider 2 Provider 3 Provider 4 Provider 5

ICD10 ICD9

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13

Internal Medicine Summary

74% 72% 70% 68% 66% 64% 62% 60% 58% 56% 54%

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Internal Med

ICD10 ICD9

14

ICD9 vs. ICD10 Obstetrics/Gyn

120% 100%

80% 60% 40% 20%

0% Provider 1 Provider 2 Provider 3 Provider 4 Provider 5

9/13/2013

ICD10 ICD9

15

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