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Strategies for Mastering Annual Code Changes

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Scot Nemchik, CCS, CRC, CLSS
January 12, 2018

Right about this time last year, we stood on the cusp of implementing over 5,500 new ICD-10-CM and ICD-10-PCS codes for the new federal fiscal year.  One year later, we find ourselves in a similar position. Thousands of new diagnosis and procedure codes are waiting in the wings, ready for their proper spot on a coded medical encounter. I thought about centering this blog on some of the eye-catching new codes, but those cats are out of the bag, and I’d merely be rehashing some code level information passed along over the past few months. What fun would that be?

Empowering code stakeholders to utilize new codes with accuracy and efficiency is a daunting task, bordering on impossible if not done correctly. To that end, I think a better use of our time would be to discuss some basic strategy for getting coders and providers prepared for annual coding changes. After all, I think it’s fair to assume we will find ourselves in a similar position next year, and the year after that, and the year after that.

First of all, there is no reason to be caught off guard by new codes. Each spring, as sure as the sun rises in the east, CMS posts information to their website detailing proposed new codes, and proposed code deletions.  Yes, these codes are not yet set in stone, but we know that proposed codes, with rare exception, usually become final codes later in the year. Suffice to say we’ll have a pretty good idea of where CMS’ head is at.

It’s important to note that CMS posts this information in uber-organized fashion.  Files are meticulously named; tables in those files convey information unambiguously. Perfect. In short, we have a very good idea of what to expect in October, as early as April. CMS tees up information for us perfectly, and with plenty of notice. We have all that we need to start to create some preliminary ‘new code awareness’ in the largest stakeholder group, our coders.  We can also use this same information to formulate our plan of attack. Which code changes will be most impactful to our organization? What is the nature of the changes? Are there trends or patterns in the changes? Are there obvious strategies that we can teach our coders to help them navigate the changes? Are there documentation implications for our providers?  We can refine our plan over the next few months, with plenty of time.

In predictable fashion, as sure as the sun sets in the west, CMS finalizes code changes in mid-August and publishes this information to their website around that same time. Again, this information is incredibly organized and very easy to work with. We can drop in on the final files, and by using basic Excel functions we can quickly identify any differences from the proposed files. We can use the next few weeks to finalize our plan of attack before we activate on it.

At this point in time, we are about a month out from the new fiscal year and feeling great about our preparation.  We’ll use September to convert awareness to mastery in our coding personnel. We’ll do this across the course of two or three webinars, encouraging dialogue the whole way.

Last, but certainly not least, we’ll address the new changes in our provider community.  We’ll be thoughtful while doing so. This is a great opportunity to build bridges between our coding leadership and the providers who ‘source’ our codes.  Being thoughtful means knowing your audience. A cardiologist doesn’t need to know about changes to ectopic pregnancy codes; changes to MI and heart failure a code, that’s a different story. Likewise, an obstetrician doesn’t need to know about changes to MI and heart failure codes; but changes to ectopic pregnancy codes; that is something they’ll want to know about.

As the calendar page flips from September to October, all that’s left to do is succeed!  We’ll be heading into the new fiscal year with confidence that we’ve empowered our coders and providers to navigate new codes and new concepts.

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