Coding Q&As

ICD-10 Coding Q&As

Ask the Coding Experts, by Doug Morrow, O.D., Harvey Richman, O.D., and Rebecca Wartman, O.D. From the June 2015 edition of AOA Focus, page 49.

AOA's Coding Experts share more solutions to your coding conundrums.

I've been told that computer-based EHRs will have the ability to pull the appropriate ICD-10 code for a doctor to report to insurance companies. If that is true, do I really need any ICD-10 training?
Ultimately, your patient record documentation is your responsibility. If you are ever audited, indicating that your EHR made an error or didn't provide you with the right codes will simply not be sufficient. Many EHRs can "pull" out a diagnosis based on information the doctor inputs into the system. However, if you enter free text, the EHR may not recognize this information in the same way and thus may not consider free text in selecting the proper diagnosis. Additionally, ICD-10 often requires more than one code be used in combination. All doctors need to learn the new system so they will understand when the EHR is pulling the proper diagnoses and when it is not.

Note that the transition to ICD-10 will bring a huge increase in the number of diagnosis codes. There are about 14,000 codes in ICD-9 and there will be about 70,000 codes in ICD-10. This increase requires doctors to understand the additional specificity involved.

Rather than rely solely on an EHR system to assist you with the transition to ICD-10, you should start with the AOA's 10-part ICD-10 webinar series to provide you with a good foundation for understanding ICD-10. Visit aoa.org/coding to access the webinars.

In ICD-10, is there a distinction between old and new retinal detachments?
In ICD-10 there are several codes to describe various kinds of retinal detachment. These can be found under H33. The codes do not distinguish between "old" and "new" retinal detachment, but you will need to review the list under H33 to determine which code describes the patient's situation.

After October 1, 2015, can I submit claims with ICD-9 codes if the date of service was before October 1?
Yes, the transition to ICD-10 is linked to the date of service. Claims with dates of service prior to October 1 should be filed using ICD-9 codes. Claims with dates of service on or after October 1 should include ICD-10 codes.

Ask the experts
AOA's Coding Experts are available to answer questions about ICD-10 and other coding topics through the online form available at aoa.org/ask-the-coding-experts.

July 28, 2015

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