November 2013

ICD-10 Preparation Focuses on Evaluating Information Gaps in ICD-9 Documentation

The transition to ICD-10 means implementing a new and detailed classification system into an already busy workplace. To ensure a seamless integration, NCH leadership has tasked the ICD-10 work groups with developing and carrying out a coordinated preparation effort.

How are we preparing for ICD-10?

An important step in preparing for ICD-10 is evaluating current ICD-9 documentation to learn if it contains enough information to be translated to the new ICD-10 codes. Because ICD-10 codes capture a deeper level of detail, there are likely many situations where more information will be needed to select the proper code. Our coding and documentation experts are evaluating medical records to identify these situations and develop a solution to be sure enough detail is captured to correctly code using ICD-10.

Throughout the evaluation process, experts are looking for:

  • Documentation issues that will slow or stop the coding process or significantly change reimbursement
  • Documentation gaps that may affect data quality and reporting, or may have significant risk for future reimbursement impact
  • Documentation holes that are expected to influence the completeness of coded data or are likely to slow the code assignment process

Physician documentation will play a critical role in a successful implementation of ICD-10. To use the more specific codes that the ICD-10 coding system offers, documentation will need to include the details necessary to accurately code. To that end, the medical record evaluation process will also help us prepare training and education that will be designed specifically for NCH documentation and utilization patterns.

Using the ICD-10 code set has the potential to improve the quality of data and reporting about our patients and the care we provide, as well as improve clinical, financial and administrative performance, and track public health and risks. As we continue towards the compliance date (October 1, 2014), NCH and the ICD-10 work groups are committed to a robust and thoughtful preparation process.

If you'd like to learn more about the transition to ICD-10, please don't hesitate to reach out to Sandra Kersten (, ICD-10 Project Manager, or Ron Tapnio (, Revenue Cycle Management Executive Director and ICD-10 Project Sponsor.