By Newkirk Products, Inc. and submitted by McPhillips, Roberts & Deans, PLC
It’s coming. The transition to the International Classification of Diseases, 10th Edition (ICD-10), Clinical Modification/Procedure Coding System will occur on October 1, 2014, and will affect everyone working in the health care field. The most significant impact on you and your practice is likely to be the increase in outpatient diagnostic codes from close to 13,000 to more than 68,000.
A Big Transition
Transitioning to the new coding system will be a challenge for medical practices. It will place stresses and burdens on practice systems and staff. The costs for training and software upgrades could be significant. However, the cost of incorrectly implementing ICD-10 could be even greater. If you do not submit claims correctly, you will not be paid for your services. And remember, there is no phased implementation for ICD-10. It is a one-day transition.
Since ICD-10 will require a far greater specificity in coding than ICD-9, it’s important that your practice lay the groundwork now to ensure a successful transition.
If you haven’t already done so, select one person to manage the process, identify what work needs to be done, and prioritize. If yours is a larger practice, you may require several people to assume different roles in helping to implement ICD-10.
As soon as possible, map out the time and costs involved in system changes, resource materials, and training. Develop a timeline for training staff on the new coding, for claims testing, and for reviewing your coders’ test results.
Most practices perform a predictable set of patient examinations and tests. Your practice may be similar and use certain codes more frequently than others. Identify those codes and have your staff determine what they will be in ICD-10.
You will need to determine whether your systems support these changes. Most electronic health record (EHR) vendors are updating their software to accommodate ICD-10 in time for the transition. However, don’t assume all vendors will be on top of things. It’s better to contact them to determine their rollout plans, the dates of the roll-outs, and what upgrades may be necessary to your systems.
Contact payers to discuss their ICD-10 preparations. Ask them to commit to a date when you can start testing claims.
Arrange for Training
Allocate a lot of time for training clinical staff and providers, coders, and IT staffers to handle the upcoming changes. The Centers for Medicaid and Medicare Services projects that 24 to 40 hours of training will be required to get coders up to speed on ICD-10. Training for clinical staff should emphasize how the documentation they provide will affect the coding process.
Allow Time for Testing
Before going live, you’ll want to test transactions contain-ing ICD-10 codes to ensure they are being successfully transferred and received. Identify where the flaws and failures may be and work closely with all stakeholders to fix any problems. This process may require multiple tests to bring your operations up to a satisfactory level.
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