ICD-10: The Coder's Perspective | ASC Coding, Billing and …


This article is written by Sherri Stinnett, CPC, Coding Services Manager, ASC Billing at SourceMedical.

There are plenty of educational and how-to articles on ICD-10, offering advice on how ambulatory surgery centers (ASCs) can prepare staff for the impending regulatory changes with minimal disruption. While the vast majority of articles discuss ICD-10 from a broad, facility-wide perspective, very few articles have been written that focus on ICD-10′s impact on coders, until now.

When considering coders, there is a common misconception about the impending pain they will face as a result of ICD-10. The assumption is coding specialists will have an extremely difficult time learning the new codes. While there will be some initial frustration, this will not be a result of the complexity of the codes themselves but rather the inconvenience of having to learn something new. Coding specialists have become very familiar with the existing ICD-9 codes; most have these codes memorized. As coders familiarize themselves with ICD-10 codes productivity initially will be slower. However, much of this frustration will be short-lived.

The biggest headache for coders will not be learning the codes, but rather getting detailed documentation from surgeons. Obtaining the necessary details to code cases has always been a challenge. With the move to ICD-10, it will be significantly more difficult. Specificity requirements will increase substantially, which means surgeons will have to provide coders with much more detailed documentation. Without the necessary details in hand, coders will be left chasing surgeons for information, claims maybe denied, and reimbursements will be delayed.

To minimize disruptions and reimbursement delays, it is essential that surgeons understand the role they will play in a facility’s successful transition to ICD-10 and, more importantly, the financial impact if they fail to provide the necessary documentation. While coders are available to assist with any questions a surgeon may have, it is up to the surgeons to undergo the necessary training to familiarize themselves with the specificity requirements and the types of documentation they must provide to coders. Because ambulatory surgery center owners and management have a financial stake in the matter, it is important that they also take an active role in encouraging surgeons to pursue the necessary training. Even though ASC staff will not be training surgeons, an open dialogue on the importance of training and documentation can prove very helpful.

Both coders and surgeons should become familiar with the new specificity requirements well in advance of the October 1, 2014 effective date. For coders, practice will be essential in helping identify any foreseeable areas where documentation is lacking. Once issues are identified, coders should begin working with surgeons to educate them on what is needed and why, as well as provide them any written documentation to explain the issue.

To help ease the process, it is also important that coders network with their peers. If one person hasn’t figured out a solution to something, it is highly likely someone out there has an additional piece of documentation that a doctor may not be offering in his op notes. The American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC) are also great resources for training and peer networking.

There is much work to be done in preparation for the transition to ICD-10. Taking advantage of the extra time to ensure coders, and surgeons, have the proper education and training will allow for a smoother transition with fewer disruptions.

Sherri Stinnett, CPC, Coding Services Manager, ASC Billing at SourceMedical.SourceMedical provides outpatient information solutions and revenue cycle management services for ambulatory surgery centers, specialty hospitals and rehabilitation clinics nationwide. With more than 5,200 satisfied customers, the company offers a broad range of solutions to the industry. Contact the author at
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