Four Steps to Avoid Making ICD10CM Mistakes
Written by Kara Silvers, CPC, CPC-I
Medical codes are used for reimbursement, research, tracking public health, and directing treatment of individual patients. Most billers and coders are more familiar with the codes in the area of reimbursement. They make sure the codes match the diagnoses and procedures and then submit them with the claims in order to be properly reimbursed. Being properly reimbursed is key in this situation and with that, being sure that all codes are correct is key.
One of the areas in which there are some significant coding errors is in the are of ICD10CM. Many of the ICD10CM mistakes made are common mistakes that can be easily avoided and corrected. Below are four of these common ICD10CM mistakes and how to avoid them.
Common ICD10CM Mistakes To Avoid
- Using outdated codes. I know this can be hard to believe, but there are people who are still using ICD9CM codes. Why? I don’t know, but they are incorrect and can quickly get your claim denied. We all know that code updates typically happen each year and we get these updates in the fall to update for the new year. Being sure that you do this each and every year is critical in terms of getting your claims submitted and reimbursed in a timely manner.
- Coding with the diagnosis code, but forgetting the procedure code. In coding, you need both a diagnosis and a procedure code. When there is a diagnosis, there is a procedure that follows. Whether it be an office visit or something along the lines of consultations, there is a procedure code to pair with the correct diagnosis code. When there is a missing procedure code, but a diagnosis code is submitted, the claim will be denied and it will have to be corrected in order to be reimbursed.
- Incorrectly transposing numbers and letters. ICD10CM codes are both numbers and letters. We should know that they all start with a letter and are typically followed by at least two numbers. There are codes that will have more than two numbers in them and can have more letters, such as the X placeholder. Looking at the first three characters should help us to be sure we have entered the correct code; however, it is quite easy to be in a hurry or not be paying attention and for letters and numbers to be entered incorrectly. This is a simple mistake that can happen and can be easily corrected by taking your time to enter the information and proofreading before submitting.
- Leaving out laterality and specificity. The one thing about ICD10CM is that it is specific to what needs to be coded. Laterality refers to which side of the body is reflected. When it is in the documentation, we need to be sure that it is added to the code. When you begin to look up codes in the ICD10CM manual, you will see how specific most of them are to the right or left sides of the body and so the codes need to be specify that. We also have specificity with ICD10CM codes. Being specific is another reason why ICD10CM was implemented. With ICD10CM, the codes are to be as specific as possible in order to match the documentation and to be properly reimbursed. This means being sure that you read all guidelines and are aware of coding conventions when using the ICD10CM coding manuals.
These are just a few of the most common ICD10CM mistakes made when coding. These mistakes are minor and can be corrected with ease. They can also cause delays in reimbursement, so the more thorough we are, the better off we are at getting reimbursed properly and timely.