Many organizations and physicians are implementing electronic medical records (EMR) with the belief that the EMR will take care of their transition to ICD-10. Although the implementation or use of an EMR can help with the documentation challenges providers will be confronted with in the new ICD-10 world, the use of an EMR alone is not a magic bullet.
With the expansion of diagnosis codes comes a greater level of detail therefore a greater level of detail will be required in the encounter documentation in order to assign an appropriate diagnosis code. For physicians that document directly in an EMR either manually or through VR, consider how much time this process take in their current workflow. Although the ICD-10-CM codes still contain entries for unspecified codes, Medicare has indicated they are considering not covering services submitted with these codes. This makes the documentation and assignment of the appropriate ICD-10-CM code much more important.
Challenges for EHRs moving into the ICD-10 world exist with the workflow for assigning and ranking the diagnoses for the patient’s encounter. In the current EMR environment, many providers are completing data elements and selecting diagnosis codes from drop-down lists. Is the physician prepared for the dramatic increase in diagnosis codes now displayed on the drop-down list? How will the physician’s workflow change when more time is needed to assign the appropriate diagnosis code? Will the EMR allow the physician to enter a descriptive diagnosis rather than a specific diagnosis code? Can the EMR support a workflow that sends patient encounters to coders for review and assignment of the most specific diagnosis code based on the physician’s documentation? Many EMRs plan to use the GEMs to crosswalk the existing diagnosis codes to the new ICD-10-CM codes. Although this plan sounds good in theory, the level of detail provided in the ICD-10 codes does not provide a one to one match. Providers who have EMRs that have mapped ICD-9 codes to ICD-10 codes should ask to review the mapping.
With the implementation of ICD-10-CM, an EMR has the potential to create more points of pain for the physician than currently exist. With careful planning, training, and education an EMR can help transition physicians into the ICD-10-CM world but it should not be considered the magic bullet.
Source: www.himss.org; Melody W. Mulaik; February 10. 2012.