ICD-10 for the emergency department


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ICD-10 starts with documentation – coders can only code what has been documented. In order to address the increased specificity required by ICD-10, it’s important to have a documentation system that guides clinicians to the right level of detail. With the fast-paced environment and the varying levels of acuity seen in episodic care settings, the right documentation system can is essential in the ICD-10 world. The resources below outline important considerations and tips for ICD-10-ready documentation systems.

ICD-10: Time to Change the Conversation

ICD-10 has been a coding conversation. I think it needs to be a documentation conversation.

How ICD-10 Implementation Affects Emergency Department Physicians

Time is precious in the emergency department (ED), where patients arrive unscheduled, the broad scope of medicine is fully encountered and rapid decisions are frequently made — in some cases with great impact on a patient’s survival.

ICD-10 for Physicians

In this webinar, Tom Ward, M.D., CMO discusses both the short and long term implications of ICD-10 for emergency physicians and what you can do to prepare.

Dear Physicians: Your ICD-10-ready EHR should look like this

"ICD-10 clinical content, feedback and code generation" is the best-case scenario for both physicians and coders, as well as for the overall goals of a hospital.

ICD-10: Questions to ask your vendor

The implementation of ICD-10 comes with many changes and challenges. Here are a few questions to ask your vendor to ensure you're prepared.

Top communication tips for successful ICD-10-CM preparation

Lack of communication creates major inefficiencies in any project plan. ICD-10 is overwhelming enough in itself; to throw in another major kink like miscommunication can create serious issues.

ICD-10 is a Documentation Problem

Is your EHR vendor prepared to support the increased documentation specificity required by ICD-10?

ICD-10 & Clinical Documentation Improvement (CDI) Strategies for the ED

Discover strategies designed to help you improve clinical, operational and financial outcomes in your ED.

Dig deeper than 'ICD-10 Compliance' for ED systems

Incomplete ICD-10 readiness plans will require quick finalization so that adequate training & testing can be done before the switch is flipped.

Upgrade Documentation Systems for ICD-10-CM

The time to start documenting for ICD-10-CM is now.



ICD-10 has increased the burden on emergency departments and other outpatient settings that are particularly challenging coding environments with high patient volumes and varying levels of acuity. In these dynamic environments, money is often left on the table from missed charges and procedures. The right systems and services for outpatient coding in ICD-10 are essential in order to ensure that revenue is being accurately captured and coded under the new classifications.

Preparing Outpatient Coding for the ICD-10-CM Transition

Jeannie Ruch, RHIA, CPC, director of coding quality covers some of the most significant changes in documentation from ICD-9-CM to ICD-10-CM and provides tips on preparing both physicians and coders to handle these changes.

ICD-10-CM from an optimistic coder’s perspective

Each coder has a reaction to ICD-10-CM as unique as the person expressing it. The emotions associated with ICD-10-CM cover the complete spectrum; from joy to grief, happiness to rage, doubt to certainty.

Your checklist for ICD-10 end-to-end testing

Starting the end-to-end testing process for ICD-10 as soon as possible is critical, as payers have said they do not have the bandwidth to test with all providers and will be testing on a first come, first serve basis.

Your checklist for ICD-10 interface testing

New and updated systems must be completely and thoroughly tested to validate proper transmission of data.

Tips for selecting the right ICD-10 encoders for the emergency department

Emergency medicine encounters have the potential to utilize multiple specialty codes that have been significantly impacted by the code expansion of ICD-10-CM.

Tips for Selecting ICD-10 Encoders for the ED

Hear about pitfalls of some common encoder types; and specific, dangerous qualities to avoid; and important features including auto-sequencing and natural-language search.

Advanced ICD-10 Strategies for Community Hospital EDs

This webinar addresses how to set expectations, clinical documentation improvement strategies and common ED visits and their code equivalents.

Top communication tips for successful ICD-10-CM preparation

ICD-10 is overwhelming enough in itself; to throw in another major kink like miscommunication can create serious issues.

Why ICD-10 is still a good idea

It's important to take a proactive rather than reactive approach to clinical documentation and (may I say it?) the revenue cycle when it comes to ICD-10.



T-System’s thought leaders are very active in industry discussions around ICD-10, bringing the emergency and episodic care perspective to the forefront and sharing their knowledge from years of research and experience. Check out these featured articles from our thought leaders.

Alleviating ICD-10 concerns

There’s no argument from either side that ICD-10 implementation is not a challenge. However, along with the challenges of ICD-10 are the advantages, and the benefits may just outweigh the risk.

T-System Announces New Patent Filed for ICD-10-CM Technology for ER Documentation

New technology helps ensure specificity while protecting physician productivity.



For everything from what physicians need to know about ICD-10 to outpatient coding to strategies for community hospitals, these webinars provide detailed tips and advice on managing ICD-10.

Preparing Outpatient Coding for the ICD-10-CM Transition

The American Medical Association (AMA) voiced opposition to ICD-10. Read our response to their concerns.
ICD 10 for Physicians
In this webinar, Tom Ward, M.D., CMO discusses both the short and long term implications of ICD-10 for emergency physicians and what you can do to prepare.

ICD-10 & Clinical Documentation Improvement Strategies for the ED

We review ICD-10 and clinical documentation improvement strategies designed to help you improve clinical, operational and financial outcomes in your ED.
Tips for Selecting ICD-10 Encoders for the ED
Hear about pitfalls of some common encoder types; and specific, dangerous qualities to avoid; and important features including auto-sequencing and natural-language search.
Advanced ICD-10 Strategies for Community Hospital EDs
This webinar addresses how to set expectations, clinical documentation improvement strategies and common ED visits and their code equivalents.
ICD-10 Delayed - Now What?
Capture additional revenue in your ED. We’ll explain our free, confidential assessment that will identify and quantify the dollars you are leaving on the table.
ICD-10 is a Documentation Problem
Is your EHR vendor prepared to support the increased documentation specificity required by ICD-10?

T-System’s full suite of products has been meticulously updated for ICD-10. A team of clinical experts spent nearly three years building in the appropriate level of specificity and terminology into the clinical content in our documentation solutions. As part of the update process for EV, T-System developed multi-level feedback technology for ICD-10 that is currently patent pending. RevCycle+’s ICD-10 encoder was developed by certified coders and physicians with a built-in hierarchy of edits, an intuitive user interface and a customizable pick list for rapid code selection.

T Sheets® for ICD-10

With clinical content and terminology that has been updated for ICD-10, T Sheets are an efficient and effective way to ensure clinicians document required level of specificity without interrupting workflow.

Learn more >>

EV™ for ICD-10

EV takes the burden out of ICD-10. Updated with the necessary clinical content and terminology for ICD-10 as well as patent pending multi-level feedback for clinicians, EV ensures a seamless transition to ICD-10.

Learn more >>

RevCycle+® outpatient charge capture and coding

Driven by quality and compliance, RevCycle+ outpatient charge capture and coding is fully updated and prepared for ICD-10, and offers a variety of different service models to meet your needs.

Learn more >>

ICD-10 readiness assessment

Our team of clinical and coding experts provide
a site-specific readiness assessment which
includes an in-depth assessment of
documentation and coding practices for
ICD-10 readiness.

Learn more >>

T Sheets® for ICD-10


The original template-based documentation system, T Sheets has been the gold standard in emergency and urgent care documentation for nearly twenty years. A team of experts reviewed and updated each T Sheet in order to ensure it included the level of specificity required to arrive at a proper ICD-10 code.




Learn more about T Sheets

EV™ for ICD-10


EV has been reviewed and updated with the clinical content and terminology necessary in order to reach the most specific ICD-10 code possible for optimal reimbursement. In addition, EV include patent pending, multi-level feedback that includes both high-level visual cues as well as the option for more detailed feedback in order to help facilitate the most specific ICD-10 code possible.




Learn more about EV

RevCycle+® outpatient charge capture and coding


With both a software as a service (SaaS) and a full service option, RevCycle+ can help reduce the burden of ICD-10.

  • Worried about having enough qualified outpatient and emergency department coders for ICD-10? Let us help with full service coding backed by a 97 percent quality guarantee.
  • Need additional training and resources for your existing coders to prepare for ICD-10? Our SaaS model allows provides access to our ICD-10 encoder which includes a built-in hierarchy of edits, an intuitive user interface and a customizable pick list for external cause.

Learn more about RevCycle+

ICD-10 readiness assessment


Our expert services for ICD-10 are fully customizable but most engagements include:

  • Documentation clinical content review that pinpoints gaps and possible areas of risk
  • 50 chart audit that assesses documentation specificity and coding accuracy
  • Physician productivity impact assessment
  • Coder query workflow review

Learn more about our ICD-10 readiness program

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