3 Simple ICD-10 “Pre-Coding” Steps to Save Transition Time in Your Chiropractic Office

For those of you who have already taken umpteen seminars, webinars or online course to help with your ICD-10 preparation, there’s one critical time saving step that will help you slide smoothly into October.

I call it “Pre-Coding.” Here’s why it is super important and what it entails.

Why You Need to “Pre-Code” Your Chiropractic Patients Now

Thanks to the fact that ICD-10 is a “hard start” there will be no dual coding. What this means in plain English is one day you will be in ICD-9 and the next, in ICD-10. While that sounds simple enough, don’t miss the fact that eventually ALL of your claims will need to be coded into ICD-10. And where this can get real messy is in the near future.

In other words, let’s say you see 30 patients a day. Come October 1, that means those 30 patients will need ICD-10 codes in place of their former ICD-9 diagnosis. Surely, this won’t cause immediate overwhelm. But unfortunately, the code conversion doesn’t stop there.

The next day, 30 more patients role in and (likely) none are the same as yesterday. So, they all need to be coded into ICD-10 as well. And the next day, it happens again. And again. Until, eventually everyone gets coded in ICD-10.

Now, contrast that with some very practical thoughts in the area of task time. If you are lightning fast, it will still take you a minute or two to transfer ICD-9 into ICD-10 codes. Multiplied by 30 patients and you lost an hour of your day (or your staff did).

ICD-10 Code Conversion Is Not as Quick as You Think!

But, as many of my ICD-10 Intensive workshop attendees have been discovering, code conversion is not as quick or simple as you would like. Online code converters are woefully inadequate and typically fail to give all available options for a code. Billing system and EMR data dumps don’t necessarily help you wade through the selections of codes. And the process of manually finding the appropriate ICD-10 codes in a code book can easily take way more than 2 minutes, especially when we consider that we typically have multiple diagnosis codes per patient.

As you can easily see, if coding were to take just 5 minutes per patient, now you are in a situation where you (or your staff) are spending 2.5 hours per day in your conversions. This can (and will) produce a massive backlog and lead to lots of late nights or expensive overtime pay.

The Pre-Coding Preparation

Worse yet, if you leave all these code conversions to October 1, you are likely to get so far behind that you will delay your billing because you don’t have the codes.

The solution? Start pre-coding NOW!

Here’s How to Pre-Code

  1. Start with patients you anticipate seeing in October. The first step is to begin with patients that you already think you will see in October because they will obviously need ICD-10 codes immediately. So, for example, if you just began care with a patient, ask yourself if that patient is likely to still be treating in a couple weeks or so. If the answer is yes, move to step 2.


  1. Pre-Code: Take your current ICD-9 codes and convert them to ICD-10 codes for this patient. Be careful to make sure that you have all applicable diagnosis codes and be forewarned that you could easily have more codes in ICD-10.


  1. Store Your Pre-Coding: Because you cannot yet use the ICD-10 codes (as dual coding is not accepted), you must then “store” these codes for future use. Keep it simple and do this in one of two ways:
  • If you are on EMR, put the ICD-10 codes in a system note, an alert box or some other section of your system that will not confuse billing or cloud your current documentation.
  • If you are still using paper charts, place a sticky note on their chart with the ICD-10 codes to be used in October and beyond.


By pre-coding you will help use your time wisely over the next two weeks and get one step ahead, rather than be (at least) one step behind in October.

Just to reiterate:  By Pre-coding, I do NOT mean that you should submit ICD-10 codes ahead of time.  You CANNOT do that.  I simply mean to prepare your office internal by converting patient diagnosis in ICD-9 to ICD-10 now, instead of later.


What to Do Next

If you have a firm understanding of ICD-10, begin pre-coding now!

If you still are not sure how to use the codes (or haven’t started training yet), it’s not too late. Consider our online ICD-10 implementation course for chiropractors and staff or attend one of our last ICD-10 Intensive live workshops prior to the October 1 date.

But hurry – the more time it takes you to learn ICD-10, the less time you have to take these preparatory steps!