6 Ways Neurology Practices Can Get Up-to-Speed with ICD-10

As with many specialties, neurology will see a variety of changes in ICD-10. Many of these changes do require additional documentation specificity, and neurologists must understand the changes. One goal of ICD-10 is to provide more detailed information for clinical research and treatment purposes. Having accurate data is paramount. Consider the following ways in which neurology practices can prepare for this monumental transition:

1. Read up on combination codes. These codes incorporate multiple pieces of information about a patient’s condition all in one code. For example, neurological complications such as neuropathy, amyotrophy, and more are included in codes for diabetes when those complications are directly related to or caused by the diabetes. Don’t report two separate codes when the two conditions are related, as this will negatively affect reimbursement.2. Review the Glasgow coma scale. ICD-10 codes allow neurologists to report either a total score or separate elements of that score related to eye movement, verbal response, and motor response. Note when this information was recorded, as it can affect the 7th character in the code.

3. Review codes for epilepsy. In ICD-10, these codes require neurologists to document the specific type of epilepsy as well as intractable versus not intractable and with or without status epilepticus.

4. Note changes for migraines. More specifically, when a patient presents with a migraine, be prepared to document the type of migraine, with or without aura, intractable versus not intractable, and with or without status migrainosus. When a patient presents with a cluster headache, the neurologist must also specify intractable versus not intractable.

5. Prepare to provide specificity for hemiplegia and hemiparesis due to sequela or cerebrovascular disease. Provide documentation pertaining to laterality and dominance. Unless otherwise specified, left hemiplegia/hemiparesis defaults to non-dominant.6. Document early onset versus late onset Alzheimer’s disease, as ICD-10 differentiates between the two. Also note whether the patient has any behavioral disturbances.

It pays to be proactive. Take the time to review the diagnosis changes that will affect the neurology practice most directly. Update superbills and templates, and be sure to educate physicians about how their documentation affects code assignment. Accurate data capture today could very well lead to clinical improvements tomorrow.