October 1, 2013 - the looming ICD-10 implementation date - is merely a couple of years from now, so how do we really need to focus our efforts with respect to terminology and anatomy and physiology (A&P)?

Last time I checked, we all still have the same anatomical parts that we did while coding in ICD-9-CM and they function in the same capacity. By the same token, medical terminology hasn't changed from its mostly Latin origin. But as we all start to prepare for the transition to ICD-10, coders will find that there are certain aspects in relation to terminology and anatomical references that will be useful in a successful transition and application of the codes. 

Gauging current A&P knowledge is considered a key element in most preparation or implementation checklists for ICD-10. Concern has likely blossomed for a variety of reasons, but one major reason is that coding is still a role that is often primarily based on on-the job ("OJT") training. In this day and age, OJT may or may not involve formal classes on medical terminology and/or human A&P -topics that are currently an integral part of the curriculum for two-year or four-year health information management programs. Rather than run to the nearest college, some organizations may find it a better option to invest in existing, competent employees who may possibly be  promoted from within. This positive practice is certainly a great mechanism to reward valuable employees and definitely helps when there is a shortage of qualified and experienced coders.

New concepts in ICD-10
In the past, the ICD-9-CM code sets weren't as burdensome because they had less detail. Some transitioned coders may have evolved from serving in another role in the HIM department, such as transcription. Since transcription includes A&P within operative notes, progress notes and history and physicals, it is a helpful foundation towards basic medical terminology. But for those with limited clinical knowledge-especially in A & P-they may struggle with new concepts in the ICD-10 system. Testing staff to gauge their understanding is essential, whether you have coders on your team with extensive clinical knowledge or coders with limited expertise. It isn't as if we don't need to know medical terminology and A&P now to correctly assign codes, but it's important as a manager to recognize the spectrum of knowledge across your coding team.

For ICD-10-CM, the diagnosis codes will require added specificity. This particular concept is not a news flash because most who now work in a coding-related field at least know that when it comes to ICD-10, there are many more options for code assignment. The code set will increase from approximately 14,000 diagnosis codes to approximately 72,000 in ICD-10-CM. Many code series have added information specific to anatomical sites such as code assignment for strokes. These codes will identify not only the cause (hemorrhagic versus ischemic) but also can identify down to the detail of what vessel was involved (e.g., vertebral artery).