EvergreenHealth prepared for coding change of patients’ medical information

With less than 70 days to go until the nationwide changeover from using the International Classification of Diseases, edition 9, to edition 10 (ICD-10), teams of staff and physicians at EvergreenHealth are on track to make this transition in how patients’ medical information is described and coded, according to Chrissy Yamada, EvergreenHealth Chief Financial Officer, who is heading the changeover, along with Jeff Tomlin, Chief Medical Officer.

August 17, 2015 10:30 am
EvergreenHealth
EvergreenHealth

The following is a release from EvergreenHealth:

With less than 50 days to go until the nationwide changeover from using the International Classification of Diseases, edition 9, to edition 10 (ICD-10), teams of staff and physicians at EvergreenHealth are on track to make this transition in how patients’ medical information is described and coded, according to Chrissy Yamada, EvergreenHealth Chief Financial Officer, who is heading the changeover, along with Jeff Tomlin, Chief Medical Officer.

The switch to ICD-10, required by the US Department of Health and Human Services of all hospitals, physicians, providers and insurers, will take place on Oct. 1. It will change the way hospitals and providers capture information about patient care by mandating new medical codes that describe what kind of health problems patients have when they seek care. Hospitals will also change the way they code how the problem is treated.

“As this community’s public hospital, we want to manage large-scale change like this seamlessly. We know that is one of the things the community expects of us. That is why we have made implementing ICD-10 a strategic priority for EvergreenHealth in 2015,” Yamada said.

Since restarting implementation of ICD-10 in February after a year’s delay mandated by Congress, EvergreenHealth has:

• Upgraded all of its Information Technology systems – including its electronic medical record systems – to be ICD-10 compliant

• Conducted what is called “end-to-end” claims testing with some of its largest payers

• Created a physician education plan and published a schedule for employed and affiliated physicians to select the classes most relevant to them for training in September on the EvergreenHealth campus

• Initiated a 12-week refresher course on ICD-10 coding for employees who currently use ICD-9 coding

• Scheduled 30-minute “ICD-10 Awareness Training” sessions for staff last month

• Created an electronic learning module for self-guided awareness training on ICD-10

• Hosted a Grand Rounds presentation for medical staff by Dr. Joe Nichols of Seattle, a nationally recognized ICD-10 expert, whose key message was that in an increasingly data-driven healthcare environment, ICD-10 represents a turning point to better data collection.

“Because ICD-10 codes are much more precise and specific than ICD-9 codes, the number of codes that health systems like EvergreenHealth use will grow by sizeable multiples. For diagnoses alone, they will increase from about 13,000 codes in ICD-9 to 68,000 in ICD-10,” Yamada said.

To illustrate the difference between ICD-9 and ICD-10, Yamada used treatment for a broken arm as an example. “Today, using ICD-9, there is no code to describe which arm is broken or which bone in the arm.  In ICD-10, we can use one code to describe which arm is broken, which bone is broken, and whether a patient is in for a first visit or a follow-up visit. If the patient is in for a follow-up visit, the code will also show how well the bone is healing.”

The new codes also capture greater detail about diseases such as the flu or chronic conditions such as diabetes. That can help public health officials and researchers know more about the way these conditions and diseases are affecting larger populations of patients. “Knowledge like that can help those of us responsible for a community’s care to take steps to treat and prevent those conditions,” Yamada said.

The more detailed information in the new codes is also useful to patients, especially if they change doctors. The greater detail in the codes will be part of their health history. In that way, it will enable a new provider to get to know a patient better and faster, Yamada pointed out.

The most common use for the codes is for hospitals, physicians and providers to bill insurance companies for patient care. “The new codes will enable hospitals and providers to give a more accurate accounting of a patient’s care to the insurer when we bill them for care. Insurers, too, are making the transition from ICD-9 to ICD-10 codes. They’ll expect to see us do exactly the right thing for a patient before they pay for care. If we don’t get it right, there is a risk that we could be underpaid or not paid at all,” said Yamada.