This is the final installment of our three-part blog series which explores why many billing systems are not equipped to meet the more stringent coding requirements we’re expecting later this year.
Our first blog post in this series discussed the ICD-10 honeymoon period and the first reason why many billing systems will fail later this year: over-reliance on simple GEMS mapping alone as the way to convert ICD-9 to ICD-10. In the second blog of the series we discussed support for the complex Code First and Excludes rules. The final blog post in this series explores the required search tools needed to find codes when you choose not to convert directly from a previously used ICD-9 code.
“Any Word” search
Your ICD-10 search engine must perform searches in the same manner that Google does. That means that the order of the words should not cause the search to fail.
Example – L89611: Pressure ulcer of right heel, stage 1
Your system should find the code even if the search is “heel stage 1 ulcer right,” since you probably will not have enough familiarity with ICD-10 to order the search terms correctly. In fact, with MediTouch, if you just knew that you observed a “stage 1 ulcer (on the) heel,” an adequate group of codes would be returned almost instantly for you to refine your choice and lateralize to the appropriate code.
Search by abbreviations or common term
Your coding system must take into account that it is natural for physicians to use common terms or abbreviations to describe a clinical condition. Some examples of abbreviations include CHF for Congestive Heart Failure or HTN for Hypertension. Instances in which ICD-10 may not use the common term include Morton’s Neuroma; in the ICD-10 coding world, there is no code defined as Morton’s Neuroma. Instead, the term is defined as “Lesion of plantar nerve.” Your system must be able to map the common term to the ICD-10 term.
Sample: Search for Morton and get corresponding “Lesion of planter nerve” codes
In our blog series we have outlined a set of “must have” advanced ICD-10 coding tools, including enhanced ICD-9 to ICD-10 mapping, providing tips on Code First / Exclusions and offering users “search friendly” functionality. Billing systems must offer these features because without them, physicians will inevitably struggle in choosing the most specific code that matches their patient’s clinical condition. We are now in the honeymoon period and during this timeframe payers will usually pay a claim if the code is close (in the same family). Remember honeymoons don’t last forever (not very romantic), be sure your software has a set of features that will make ICD-10 coding work, even after the honeymoon period.