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How will the increased level of A&P be used in 2014 with ICD-10? - Sunny

Posted: Sep 11, 2012

Does anyone know exactly why ICD-10 will require a greater knowledge of A&P? What else are we going to need more of? Why?

Answer - ICD-10 instructor

[ In Reply To ..]
Since I do not know if you are a coder already or a prospective student, I do not know why you are asking and will not be able to give a good answer.

The generic answer is that 10 is more detailed than 9 and requires more knowledge in order to select codes correctly. It is not just A&P, though. While that is part of it, you also need more pathophysiology. You need to knowmore about what diseases are, about their causes, signs and symptoms, what pathological changes occur, and so forth.

Coders who never had these courses, like some who learned on the job or in an AAPC-type program, may have difficulty with diagnosis coding. We already see that when those coders simply cannot code things like heart failure, hypertension, renal disease, and cancer, but it will get worse. More detail has already been added to 9 and we hear coders complaining about it. They think it is overkill and just too hard. "How am I supposed to know that? I'm a coder, not a doctor."

Coders will just need more knowledge. A lot are squeaking by now, but it will become harder to fly under the radar. This is especially true fof inpatient coders.

Inpatient coders have a special problem. the procedure codes in 10 are nothing like the old ones. For 10, you have to build every code as you go. Each is specific for the situation. You will not be able to memorize a lot of codes and keep using them over and over.

You will have to be able to say what catelegory of procedure it is, what end purpose it serves, the body system, the exact anatomy affected, and hw it is done, with what, and other things. You need a very detailed knowledge of anatomy for this - like the vascular anatomy of the upper arm. When does one artery divide and become known as something else? Where is a particular muscle located? In what ways are certain procedures performed and what types of stents, implants, etc. can be used?

MTs who have a lot of op note experience will have an advantage, I think.

A lot of coders are running around taking A&P courses willy-nilly and vendors are making money off this. Local chapters of professional organizations here are offering the same A&P taught in junior college HIT programs. I think it is silly because it is not enough. Those courses do not teach the level of detail that will be required. They do not teach pathophysiology, either. They are being marketed to coders who already had that in college and it was not enough. The watered-down pathophysiology course most programs use is not enough, either.

There are new books being published. I think the AMA and OptumInsight publish a couple. They are specifically or 10. One, at least, is specifically for procedures.

If you are looking for an A&P book, I would recommend Marieb - the big one, too. Or, try skipping it and going straight for pathophysiology. Porth is the most challenging, Huether and McCance second, and Gould third. Do not get anything else, especially not books intended for junior colleges or adult ed. Porth and Huether & McCance are for BSN and ARNP programs. You can understand them. They review anatomy in each section, which is why I think you can skip getting an anatomy text. Between Porth, say, and the AMa book, you should have what you need.

You do not need the latest edition of the pathophysiology books, but I would keep it within 5 years. Get one or two editions back. They are often quite cheap on Amazon.com.

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