TBCE:  ICD-10 "NOT an Option"
Written by Editor   
Tuesday, October 27, 2015 10:18 AM

There has been a great deal of confusion regarding the implementation of the ICD-10 diagnostic coding system.  The TBCE reports that “it is a federal requirement that you comply, regardless of what kind of health insurance your patients have.  It’s every HIPPA covered entity.  This includes cash practices.  You are not exempt."

“You must give your patients a … receipt that has the correct International Coding Diagnostic (ICD) 10 coding for them to submit to their insurance company to get proper reimbursement for the services they received from your office."

The TBCE reminds us that “specificity and laterality must be considered when using ICD-10 codes.  There are different ICD-10 codes for right and left sides of the body."

Also note that “your documentation must match the ICD-10 diagnosis codes.  Careful documentation is also important for auditing purposes. … There are some basic documentation principles that you can use to help make your job easier:"

  1. Outline a complete history of the patient’s condition.

  2. Highlight potential red flags and risk factors. 

  3. Illustrate how the patient’s condition was monitored and evaluated.

  4. Include details on why decisions were made.

  5. Focus on teamwork between medical, coding and billing staff to communicate the patient’s condition, progress, and decide evidence.


Source:  http://www.tbce.state.tx.us/NewsLetter/2015/NLOct2015.pdf