Fast-Track Your ICD-10 Prep with Helpful Tips for Your Emergency Department

After much debate about a possible implementation delay, ICD-10 is all set to “go live” on October 1, 2015. As your Emergency Department (ED) coding team brace up for the transition day, don’t forget to be mindful of these coding priorities for emergency medicine that your staff will need to successfully manage.

At this stage, your coding team need to be proficient in ICD-10 by coding parallel to ICD-9 on live charts that go through an internal audit process. This will provide an opportunity to each coder to fine-tune any areas that require immediate attention and remediation.

Here are some simple tips on top emergency medicine diagnosis areas that your ED can do with:

1. Headaches and Migraines

One of the most common problems emergency department handles is headaches and migraines. Coding for headaches and migraine can be challenging because of the level of specificity required in ICD-10. For instance, the table lists two common ICD-9 codes and their crosswalk to the comparative codes in ICD-10.

2. Musculoskeletal Pain and Injuries

For physicians and coders, Chapter 13 is the trickiest section of ICD-10. The diseases of the musculoskeletal system and connective tissue will require a much higher level of specificity for documentation of location, type of disorder and external causes of problems. For instance, patient’s with back pain is common in an emergency department, and physician need to provide the exact location and cause of back pain. Additionally, coders should also mention if other areas are involved.

3. Sepsis

When you are coding for infection, report it first if it’s a primary problem followed by the non-infectious condition such as trauma.

4. Hemiplegia

If you are coding for hemiplegia and hemiparesis in ICD-10, it’s critical to mention if it’s a dominant or non-dominant side. According to the ICD-10 guidelines, if you have documented the affected side but not specified as dominant or non-dominant, your code selection will be considered as follows;

• For ambidextrous patients, the default should be dominant;

• If the left side is affected, the default is non-dominant; and

• If the right side is affected, the default is dominant.

5. Pain

If you don’t know the definitive diagnosis then you don’t have to report pain unless the reason for the encounter is pain control or management of pain, and not treatment for the underlying condition. For instance, if the pain is documented as acute or chronic, category G89 is used. Codes from G89 are generally reported first, followed by the site if the encounter is specifically for pain management; however, if the encounter is for other than pain control or pain management without a definitive diagnosis, assign a code for the site of the pain first followed by a code.

ICD-10 transition date is only few months away, and it’s time your agency prepares a solid foundation for the ICD-10 conversion. If you are wondering how to step-up your preparation, check out ProfEdOnDemand’s specialty-specific ICD 10 Coding Training conferences.