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2 Tactics for ICD-10 & VBP Clinical Documentation

Karen Minich-Pourshadi, for HealthLeaders Media, February 6, 2012

Thanks to value-based purchasing and the ICD-10 transition, clinical documentation is on the mind of most every healthcare leader. How accurately a patient's hospital visit is documented will ultimately affect VBP incentive payments and whether reimbursements dip, grow, or stay the same during the ICD-10 transition. Millions of dollars are hinging on your clinicians and coders, so here are two tactics to help you tackle these transitions.

1. Ease in ICD-10 codes now. Clinicians have been documenting patient records under ICD-9 for years. Although there were far fewer codes, documentation still often came up short. So it's not surprising that physicians, nurses, and coders find it a bit daunting to think about the number of new codes required by this 2013 transition—from 17,000 to approximately 141,000 ICD-10 codes.

The leaders at Mayo Clinic in Rochester, MN, are applying this technique. With 212 IT systems spanning a network of physician practices and hospitals across Arizona, Florida, Minnesota, Wisconsin, and Iowa, the Mayo Clinic faces a major task in the coding transition, just from the sheer magnitude of the organization. Mayo's goal, not unlike many healthcare systems nationwide, is for the ICD-10 transition to be revenue-neutral. To meet that end, managers started working with their clinical staff early on, and determined that a slow introduction to ICD-10 would be better received than a full-scale launch on Oct. 1, 2013.

"Instead of one choice for a headache now, there may be five to 10 choices [for codes] and that takes a little getting used to, but to have it happen all at once is very hard on the physicians," says Jeff Thompson, MD, physician lead across the Mayo enterprise.

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