by Angela Gerbert, BS, CCS, CDIP, CIC, COC, CPC-I
Changes to the ICD-10-CM and ICD-10-PCS code systems and guidelines for FY 2021 have been released. Many coders are busily reviewing the updates and making preparations for implementation on October 1. For those of us who live neck-deep in coding it is an exciting time.
While not as overwhelming as some years, FY 2021 code updates carry a few significant changes we will all do well to prepare for. How can you make the most of the time between now and October 1 to ensure your staff, your providers, and your revenue cycle are prepared?
Know what the changes are
Now is the time to study the updates and know what they mean. While significant changes to how diagnoses or procedures are coded tend to jump out, even a simple word change, a slight change to the guidance, needs to be understood in detail. For example, while everyone may be focusing this year on the coding of COVID-19, Lynn Kuehn, author of our FY 2021 Updates for CM and PCS reminds us that sometimes it is the little things, like a change to the Excludes note at D61 and how it will change the coding of neutropenia and chemotherapy-induced pancytopenia, that can cause coding errors if not understood.
Model the impact of the changes on your organization
2020 has already seen significant changes to coding and reimbursement for telehealth in response to COVID-19. It was on the coders to work with providers and revenue cycle to ensure their documentation was accurate and sufficient and that the coding was compliant with the coding rules at the time of discharge. It was a good opportunity for coders to demonstrate their value.
Even without such a significant and publicly visible change, coders are the front line to ensure their organization is ready to work with the new rules on October 1. We recommend taking the new codes and guidelines out for a spin: use your own cases and code them according to the changes. How does the documentation need to be improved to support the new rules? What changes to the charge master or billing system will need to occur? What will these new rules do to the reimbursement your organization is counting on? For example, this year’s guidelines for coding COVID-19 will change some previously-published examples and some code changes will invalidate previously-published Coding Clinic advice.
Determine who else needs to know
By understanding the changes to the coding system well before implementation, coders have the opportunity to ensure everyone who needs to know ahead of time does. The coder, as the one within the organization most knowledgeable about the coding system, is best positioned to help everyone prepare.
- Providers. A significant change to the definition of a code might require providers to document additional information in their progress notes. Knowing this ahead of time saves everyone a query. For example, the FY 2021 changes to the stages of chronic kidney disease or the use of specific devices for ankle fusions or kyphoplasty.
- Auditing and CDI. The auditing or CDI teams can start now to incorporate the FY 2021 changes into their target list. Don’t wait for the outside auditors! Preparing now will help reduce rejected claims and claw backs in the future.
- Revenue Cycle. The revenue cycle team can evaluate their systems to ensure they are ready to flip the switch on October 1 and accommodate the changes.
Make use of the time you have
One of the particular challenges of being a coder is having to often carry two years of code sets in your head and know when to apply each. Our world will change slightly on October 1 and coders need to be prepared. Investing the time now will avoid problems later.
If you are responsible for a team of coders, preparation is key to position your organization for ICD-10 FY 2021 update success.
- Determine who needs to learn what. All coders need to know the changes to ICD-10-CM, the diagnosis coding system. In addition, your inpatient coders, auditors, and CDI need to know the changes to the ICD-10-PCS procedure coding system.
- Give them tools. Anyone studying the updates will need access to the new code set and guidelines. It can be slow-going if they are studying on their own. Courses that explain the changes, what they mean, and how to apply them will give your coders a head start on the knowledge and confidence they will need to apply the FY 2021 changes. (Libman Education has in-depth and detailed courses on the FY 2021 updates)
- Give them time. Really understanding the code updates is not a one-and-done activity. It takes a bit of study and a bit of practice, but it will be time well spent.
Implementation is October 1! FY 2021 ICD-10-CM and ICD-10-PCS Coding Updates
Detailed explanations of critical changes to the ICD-10-CM and ICD-10-PCS codes and guidelines. Learn what the changes mean and how to apply them.
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