The conventional wisdom is that medical practices are going to have problems when healthcare payers want more specific ICD-10 codes.

Will it really be a problem?

Maybe medical practices are assigning very specific ICD-10 codes already, and they're going to do just fine.

The American Health Information Management Association (AHIMA) has some advice on how to assess a medical practice's ICD-10 specificity.

Start by asking some questions:

  • How often are unspecified ICD-10 codes assigned?
  • Do the non-specific codes form patterns?
  • Does clinical documentation allow more specific ICD-10 coding?
  • Is the electronic health record (EHR) using faulty logic to assign unspecified ICD-10 codes?

It's possible that medical practices are already assigning proper, specific ICD-10 codes, however, it should only be unspecified

while you are awaiting the diagnostics you are performing to come up with a definitive code.

 Tip: use an unspecified to call for authorization when using a biopsy, or CT Scan

Christine Taxin
36 Abington Avenue
Ardsley New York 10502
United States of America