Extra time will be required to verify ICD-10 codes, both in correct code selection and validation of code completion. Interpretation of codes during diagnosis validation of physician orders will require more time as well. Medical necessity verification processes will be impacted through requiring ICD-10 levels of data. A solid understanding of ICD-10 will allow all registration and scheduling staff to evaluate ICD-10’s impact to their job duties. Education should focus on the meaning of ICD-10-CM and ICD-10-PCS codes, changes in specificity and impact on severity of illness and length of stay criteria, and the differences between ICD-9 and ICD-10. (ICD-10 and the Delivery, …show more content…
Professional nurses are usually assigned the task of monitoring admissions with a focus on clinical guidelines and intervention to provide coordination of care. Case managers ensure that patients are admitted and transitioned to the appropriate level of care, are advocates for the patients, manage resource utilization, monitor outcomes data, and address the psychosocial needs of the patient. ICD-10 impacts will require case managers will need to evaluate all of their processes as it relates to determining medical necessity, appropriateness of case, referrals, utilization, authorization, and certification. Case managers will need to become familiar with ICD-10 and advanced clinical treatment guidelines based on the expanded information available through ICD-10. ICD-10 documentation training will be a necessity for case managers. (ICD-10 and the Delivery, 2013) The charge capture function will be impacted by ICD-10 in several ways. ICD-10 impacts the charge data master in medical necessity and code mapping. Lab, radiology, and other ancillary departments will need to understand ICD-10 diagnostics and medical necessity. (ICD-10 and the Delivery,