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