Top Ten ICD-10 Tips for Oncology Practices

August 15, 2015

In the long term, ICD-10 has the potential to benefit oncology through improved data collection, but right now, practices just need to focus on preparing for the change. Here are 10 tips for oncologists.

The inherent specificity in ICD-10 will likely be a goldmine for oncology research. That’s because ICD-10 includes anatomical specificity, laterality, and more that can eventually be used to improve clinical protocols and perhaps even drive individualized medicine. However, oncologists and their practice staff members must understand the coding and documentation changes included in this new system so they can ensure accurate data capture. Consider the following tips to prepare.

1. Don’t ignore ICD-10. It’s coming in a matter of weeks. If oncology practices haven’t yet begun the transition, it’s imperative that they start now. Ensure that coding staff members have proper training so they can, in turn, educate physicians. Physicians may also require separate specialty-specific training. Next, begin documentation reviews to focus on diagnosis code changes in ICD-10-CM.

2. Document laterality and the specific area of the breast in which cancer is present (eg, nipple and areola, central portion, lower inner quadrant). Note that many other types of malignant neoplasms require this information as well. Take the time to review the coding book to familiarize yourself with these changes.

3. For primary liver cancer, document the specific type of cancer.

4. Document the specific portion of the colon in which a benign neoplasm exists. ICD-10 includes the following options: cecum, appendix, ascending colon, transverse colon, descending colon, and sigmoid colon, and unspecified. This information was not required in ICD-9.

5. Lymphoma codes require documentation of the type of lymphoma as well as anatomical specificity.

6. Note that Sickle-cell disorders are combination codes. Document the type of disease, with or without crisis, and the specific type of crisis.

7. In ICD-10, if a patient is admitted for treatment of anemia due to or associated with a malignancy, report the malignancy as the primary diagnosis. Note that this is the opposite of what ICD-9-CM guidelines require.

8. Review templates and superbills to identify code changes, including requirements for additional specificity. Many oncology codes require laterality and anatomical detail. Other codes are completely new, such as those that denote specific types of male breast cancer.

9. Ask coders to create cheat sheets and work with the practice’s EHR vendor to ensure that any electronic templates have been updated.

10. Don’t get overwhelmed. The ICD-10 transition is completely manageable. However, practices need to act now. Waiting until after the go-live date to “figure it out” is not advisable.