IMPROVING ACCURACY IN ICD10CM CODING FOR HOME HEALTH CARE

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Improving Accuracy in ICD-10-CM Coding for Home Health Care

1. Welcome

1.1 Welcome

Notes:

Welcome to Improving Accuracy in ICD-10-CM Coding

1.2 Objectives

Notes:

Upon completion of this module you should be able to:

• Identify the changes implemented with ICD-10-CM that may impact accuracy of coding

• Accurately apply the appropriate ICD-10-CM code based on established coding standards and guidelines

1.3 ICD-10 Is Here!

Notes:

Advocates for and experts on ICD-10-CM coding have agreed that it provides better information and data which will improve client care, care coordination and overall disease management. While few will argue those outcomes, the challenge for those responsible for coding is appropriate application of the concepts so that the most accurate information is being entered and utilized.

1.4 Impact of Inaccuracies

Notes:

Coding, along with the supporting detailed documentation, is critical to the home care agency and home care client. Inaccuracies and incongruencies in documentation and coding can lead to frustration for agencies, payers, and ultimately the clients. With the implementation of ICD-10-CM Coding, accuracy in coding as well as compliance with coding standards and guidelines is more important than ever before.

1.5 Navigation

Notes:

This module is designed to help gauge your understanding of the changes that were made in ICD-10 and improve your ability to accurately apply the codes to real-life scenarios. You will have the opportunity to code 8 different scenarios, compare your answers to the actual codes and review the rationale for choosing those codes. Tips for improving accuracy will also be shared.

Before we begin, you may want to take a moment to review the changes implemented with ICD-10-CM. To do so, click on "ICD-10 Changes".

Otherwise, if you are ready, you can click on "Scenarios" to get started!

2. ICD-10-CM Changes

2.1 Advantages to ICD-10-CM

Notes:

The changes implemented in the codes set with ICD-10-CM will have a great impact on patient care, healthcare research as well as agency efficiency and performance. Here are just a few of the advantages seen with ICD-10-CM.

2.2 Code Characteristics

Notes:

The reason for this improvement is related to the changes in the code structure for ICD-10-CM.

The code expanded from a potential of 3-5 characters to up to 7 characters in length. This increase allows for more specification in the code. The code uses a decimal point after the 3^rd character just as in ICD-9. The first 3 characters are referred to as the category code. Some codes have a 4^th, 5^th, 6^th, and/or 7^th character that appear after the decimal point. These characters may be used to provide more disease or injury specific information such as etiology, anatomic site, and severity.

As its predecessor, ICD-10-CM is always alphanumeric, meaning that it is a combination of letters and numbers. The first character is always alphabetic with every letter used except for the letter U. The World Health Organization reserved the letter U for future use of conditions not yet identified. The second character in the code is always numeric and the remaining characters can be alphabetic or numeric.

ICD-10-CM incorporates the use of a dummy placeholder. This placeholder is the letter x in certain 6 or 7 character codes. This placeholder is there for future expansion of information on the codes, whether it be new diagnoses in the chapter, new complications, or even new types of follow-up care.

2.3 Code Concepts

Notes:

ICD-10-CM also contains a number of new code concepts or changes. Click on each of the aspects listed here to learn more.

Laterality (Slide Layer)

Pregnancy/Postpartum (Slide Layer)

Episode of Care (Slide Layer)

Excludes Notes (Slide Layer)

Diabetes (Slide Layer)

Asthma (Slide Layer)

Underdosing (Slide Layer)

Condition Timeframes (Slide Layer)

Burns and Corrosions (Slide Layer)

Z Codes (Slide Layer)

2.4 Combination Codes

Notes:

ICD-10-CM strengthens the use of combination codes. This is an effort to decrease the number of necessary codes. Often patients with certain conditions have common manifestations and/or symptoms due to their disease condition. Here are two examples of diagnoses with their common manifestations or symptoms. Click on each diagnosis to view the ICD-10-CM combination code compared to the codes used in previous versions for the same diagnosis.

2.5 Letter/Number Confusion

Notes:

With the use of a combined alphanumeric code in ICD-10-CM, it is important to use caution in reading or entering the codes due to the potential for character confusion. This is especially a concern when handwriting codes prior to entering them into the computer. This list provides examples of some of the potential areas for confusion.

2.6 Navigation

Notes:

Now that you have refreshed yourself on the changes implemented with ICD-10-CM, you are ready to move on to putting the code into practice. You can click on Scenarios to get started.

3. Scenarios

3.1 Resources for Coding Practice

Notes:

Before we begin, you will need to gather some tools in order to code the scenarios.

First, you will need to have an ICD-10 CM code book in order to look up the appropriate codes. If you don't have one, you can click on the Link to the CMS website which provides online access to the ICD-10-CM Codes. The link will open in a separate browser window so you can access the codes while going through the scenarios.

You may also want to have paper and pen available to take notes as you go through the scenarios and look up the codes.

I will wait here while you gather these items. When you have everything you need, click the next button to get started with the first scenario.

3.2 Scenario 1

Notes:

Click The Scenario button to gather information from the client's record.

Then click on The Codes button o answer the coding related questions associated with coding this clients care.

Finally, click on the Rationale button to learn more about how to correctly code this client's diagnoses and care.

Scenario (Slide Layer)

The Codes (Slide Layer)

Rationale (Slide Layer)

3.3 Finding Additional Information

Notes:

As we just learned, sometimes documentation on the client does not always readily have the information needed for an accurate code. If this is the case, prior to entering an unspecified code, there are other steps a coder can take to obtain the information necessary to accurately code the case. Listed here are a series of potential actions for the coder to take to gather the additional information necessary to correctly code a case. Click and drag the action to box you think is appropriate, then click on "See Correct Answer" to see how you did.

Feedback Layer (Slide Layer)

3.4 Choose a Scenario

Notes:

Now that you are familiar with how the scenarios work, you can continue to practice applying the ICD-10-CM codes to the rest of the scenarios. You can click on each scenario in order or you can jump to the scenario of your choosing. When you have gone through each scenario, you can use the next button to move on.

3.5 Scenario 2

Notes:

Click The Scenario button to gather information from the client's record.

Then click on The Codes button to code the clients care based on the scenario. You can click on The Scenario button to review as necessary while completing the coding.

When done entering your codes, click on "Submit the Codes" to compare your answers to the correct codes for the scenario.

Finally, click on the Rationale button to better understand the choice in codes.

Scenario (Slide Layer)

The Codes (Slide Layer)

Rationale (Slide Layer)

3.6 Scenario 3

Notes:

Click The Scenario button to gather information from the client's record.

Then click on The Codes button to code the clients care based on the scenario. You can click on The Scenario button to review as necessary while completing the coding.

When done entering your codes, click on "Submit the Codes" to compare your answers to the correct codes for the scenario.

Finally, click on the Rationale button to better understand the choice in codes.

Scenario (Slide Layer)

The Codes (Slide Layer)

Rationale (Slide Layer)

3.7 Scenario 4

Notes:

Click The Scenario button to gather information from the client's record.

Then click on The Codes button to code the clients care based on the scenario. You can click on The Scenario button to review as necessary while completing the coding.

When done entering your codes, click on "Submit the Codes" to compare your answers to the correct codes for the scenario.

Finally, click on the Rationale button to better understand the choice in codes.

Scenario (Slide Layer)

The Codes (Slide Layer)

Rationale (Slide Layer)

3.8 Scenario 5

Notes:

Click The Scenario button to gather information from the client's record.

Then click on The Codes button to code the clients care based on the scenario. You can click on The Scenario button to review as necessary while completing the coding.

When done entering your codes, click on "Submit the Codes" to compare your answers to the correct codes for the scenario.

Finally, click on the Rationale button to better understand the choice in codes.

Scenario (Slide Layer)

The Codes (Slide Layer)

Rationale (Slide Layer)

3.9 Scenario 6

Notes:

Click The Scenario button to gather information from the client's record.

Then click on The Codes button to code the clients care based on the scenario. You can click on The Scenario button to review as necessary while completing the coding.

When done entering your codes, click on "Submit the Codes" to compare your answers to the correct codes for the scenario.

Finally, click on the Rationale button to better understand the choice in codes.

Scenario (Slide Layer)

The Codes (Slide Layer)

Rationale (Slide Layer)

3.10 Scenario 7

Notes:

Click The Scenario button to gather information from the client's record.

Then click on The Codes button to code the clients care based on the scenario. You can click on The Scenario button to review as necessary while completing the coding.

When done entering your codes, click on "Submit the Codes" to compare your answers to the correct codes for the scenario.

Finally, click on the Rationale button to better understand the choice in codes.

Scenario (Slide Layer)

The Codes (Slide Layer)

Rationale (Slide Layer)

3.11 Scenario 8

Notes:

Click The Scenario button to gather information from the client's record.

Then click on The Codes button to code the clients care based on the scenario. You can click on The Scenario button to review as necessary while completing the coding.

When done entering your codes, click on "Submit the Codes" to compare your answers to the correct codes for the scenario.

Finally, click on the Rationale button to better understand the choice in codes.

Scenario (Slide Layer)

The Codes (Slide Layer)

Rationale (Slide Layer)

3.12 Review

Notes:

You have completed all the practice scenarios! By practicing application of the concepts to patient scenarios on a regular basis, you will be better prepared to accurately and appropriately put the new code features into practice.

If you would like to review any of the scenarios or ICD-10-CM changes, simply click on the appropriate button. Otherwise, click on the next button to continue.

3.13 Check Your Understanding

Notes:

The questions that follow will help you decide if you are retaining what's important.

For each question, choose an answer and then click the Submit button at the bottom of the player.

3.14 Assessment Question 1

(Multiple Choice, 10 points, 1 attempt permitted)

Correct	Choice
	True
X	False

Feedback when correct:

That's right! You selected the correct response. The ICD-10-CM code structure is always alphanumeric, meaning that it is a combination of letters and numbers. The first character is always alphabetic and every letter is used except for the letter U.

Feedback when incorrect:

Sorry - that is not correct. The ICD-10-CM code structure is always alphanumeric, meaning that it is a combination of letters and numbers. The first character is always alphabetic and every letter is used except for the letter U.

Correct (Slide Layer)

Incorrect (Slide Layer)

3.15 Assessment Question 2

(Multiple Choice, 10 points, 1 attempt permitted)

Correct	Choice
X	True
	False

Feedback when correct:

That's right! You selected the correct response. Documentation of a diagnosis becomes even more crucial in ICD-10-CM.

Feedback when incorrect:

Sorry - that is not correct. Documentation of a diagnosis becomes even more crucial in ICD-10-CM.

Correct (Slide Layer)

Incorrect (Slide Layer)

3.16 Assessment Question 3

(Multiple Choice, 10 points, 1 attempt permitted)

Correct	Choice
	True
X	False

Feedback when correct:

That's right! You selected the correct response. In ICD-10-CM we define an acute Myocardial Infarction as being 4 weeks from onset of symptoms. An old MI would be coded after the 4 week period from onset of symptoms has lapsed.

Feedback when incorrect:

Sorry - that is not correct. In ICD-10-CM we define an acute Myocardial Infarction as being 4 weeks from onset of symptoms. An old MI would be coded after the 4 week period from onset of symptoms has lapsed.

Correct (Slide Layer)

Incorrect (Slide Layer)

3.17 Assessment Question 4

(Multiple Choice, 10 points, 1 attempt permitted)

Correct	Choice
X	True
	False

Feedback when correct:

That's right! You selected the correct response. In ICD-10-CM we define an acute Myocardial Infarction as being 4 weeks from onset of symptoms. An old MI would be coded after the 4 week period from onset of symptoms has lapsed.

Feedback when incorrect:

Sorry - that is not correct. In ICD-10-CM we define an acute Myocardial Infarction as being 4 weeks from onset of symptoms. An old MI would be coded after the 4 week period from onset of symptoms has lapsed.

Correct (Slide Layer)

Incorrect (Slide Layer)

3.18 Assessment Question 5

(Multiple Choice, 10 points, 1 attempt permitted)

Correct	Choice
	True
X	False

Feedback when correct:

That's right! ICD-10-CM makes a distinction between what is classified as a burn and what is classified as a corrosion. A burn is due to a heat source such as fire, electricity, radiation (except sunburns), and appliances (stoves, curling irons, etc.). Corrosions are injuries due to chemicals, whether they occur due to acid or other caustic substance.

Feedback when incorrect:

Sorry - that is not correct. ICD-10-CM makes a distinction between what is classified as a burn and what is classified as a corrosion. A burn is due to a heat source such as fire, electricity, radiation (except sunburns), and appliances (stoves, curling irons, etc.). Corrosions are injuries due to chemicals, whether they occur due to acid or other caustic substance.

Correct (Slide Layer)

Incorrect (Slide Layer)

3.19 Congratulations

Notes:

This concludes this module. You can use the menu tab at the top left of this screen to review any of the content just covered.

When you are ready, you can move on to the next step in this course by using the course navigation.

6 DIRECTOR’S MESSAGE ON SECONDHAND SMOKE IMPROVING THE
66 PRESS RELEASE FIRST HALF 2013 IMPROVING RIG MOMENTUM
A FSANZ DISCUSSION PAPER IMPROVING FOOD SAFETY FOR

Tags: accuracy in, improving accuracy, improving, icd10cm, accuracy, coding, health

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