ICD-10 & Hamilton
ICD-10 Implementation is an investment in time, but it presents physicians with 5 benefits that have the potential to be major game-changers:
- Ensure your strong reputation. With Value-based purchasing, and Physician report cards (Healthgrades, Leapfrog Group, etc), documentation becomes the basis for the ICD-10 codes, which will more accurately reflect the quality of care provided by a physician.
- Grow compensation and reimbursement. The greater the detail in the physician notes, the more accurate coding can be in ICD-10. This will result in accurate and fair physician and hospital compensation and reimbursement for goods and services. It is important to note that ICD-10 does not require a change in how physicians practice medicine or treat patients. Rather it demands more accurate and complete documentation and gives physicians more diagnostic choices to capture new data to ensure physicians are paid for the complex work they perform.
- Determine the Severity of Illness (SOI) and Risk of Mortality (ROM) and Prove Medical Necessity. ICD-10 codes are much more granular and provide choices that will allow the reality of the patient’s condition to be encapsulated into a unique code based on the physician’s documentation. SOI and ROM reflect the patient’s level of sickness. As a general rule, sicker patients are more expensive to treat because they utilize more resources and have a higher rate of complications and likely worse outcomes.
- Reduce the hassle/Improve the outcome of audits. ICD-10 codes will allow the physician’s documentation to be translated into a more accurate clinical picture, thereby reducing the chances of misinterpretation by third parties, auditors, and attorneys.
- Data mining and research opportunities. ICD-10 will trigger a deeper level of clinical detail in the medical record. This information can be used to gain access to better clinical information that can ultimately reduce errors, impact multidisciplinary care, and provide improved assurance of appropriate reimbursement.
Lisa Kocher, Clinical Documentation Specialist
706.272.6000, ext 3836
Rodney Thames, Patient Accounts Manager
Shannon Malone, RHIA, Coding Compliance Supervisor
706.272.6000, ext. 3339
Selena Lidderdale, RHIA, Director of Health Information Management
706.272.6000, ext. 1143
Printable tip cards
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