Survey Shows that Physicians Are Not Ready for ICD-10 Implementation

A recent report by the American Academy of Professional Coders (AAPC) indicates that only 63% of providers’ current documentation is sufficient to support the greater specificity required of ICD-10 implementation.  Over a period of six months, AAPC conducted 20,000 audits of clinical documentation to determine the physicians’ readiness for ICD-10 implementation.  Over 30 specialties were evaluated, including primary care, internal medicine, hospital-based medicine, pediatrics, urgent care and general surgery.

In most cases, the documentation did not support the diagnosis code billed, which caused a significant compliance concern.  In other cases, the charts were coded incorrectly, which exposed the provider to loss of financial reimbursement in the event of a payer audit.  Finally, several instances of billing lower codes than were documented were found.  In these instances, opportunities for revenue enhancement were identified.

The results of these assessments introduced physicians to the clinical documentation requirements that will begin in October 2014, when ICD-10 implementation takes effect.  These practices benefited by early identification of deficiencies that will cause high risk areas upon implementation.  Also of importance, physicians and employees that participate in an independent assessment can now identify specific training and education needs.

Physicians and practices that have not yet undergone an assessment should do so now.  ICD-10 implementation is less than a year away.

The complete AAPC report, including all specialties reviewed, can be viewed here.

Nancy Clark is a Manager in the Health Care Services Group. Her expertise focuses on coding and documentation audits, which includes chart review and report compilation.

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