With ICD-10 officially one year away, a few questions should be on your mind. Have you started researching the most commonly used CPT codes? Do you have a training plan in place for your staff? Will your health IT vendor’s software be updated to ICD-10 standards?
All of these questions are important in light of the October 1st, 2014 ICD-10 deadline. And with ICD-10 increasing the number of CM and PCS codes from ICD-9’s 17,000 to a formidable 141,000, it’s completely normal to feel a bit nervous.
But that doesn’t mean you should freeze like a deer in the headlights because, as always, PYP is here to quell your coding worries. Today, we’ll address ICD-10’s biggest concerns and provide you with the resources you need to fix them.
Lower Reimbursements
It’s simple. If you don’t submit the correct code for the service provided, you won’t be paid accordingly. But with more than nine times as many codes coming mistakes are bound to increase at least temporarily.
To cut down on errors, you should consider implementing practice management software that will be prepared for the ICD-10 transition. If you already have PM software, make sure to ask about your vendor’s strategy for dealing with the new coding set moving forward.
CMS suggests asking your current or potential software vendor these questions to help get the ICD-10 conversation started off on the right foot.
Decreased Productivity
Some confusion is inevitable during the initial transition period, but if coding-related slowdowns start affecting the number of patients you can treat each day, you may have to make an investment in professional ICD-10 training.
It’s better, though, to develop a transition plan ahead of time by preparing your financials and scheduling staff training sessions early. Quizzes, webinars and gamification offer substantial training benefits.
Sites like FindACode.com feature ICD-10 training games. But remember you can gamify the training experience yourself. For example, use the review and test method but add a competitive component to it. The person who grades the highest on ICD-10 quizzes receives an extra vacation day or a small bonus.
Also, PYP created this ICD-10 Resource Guide with the best ICD-10 tools from around the web to help you easily move away from ICD-9.
Documentation Problems
Payers have never been fond of reimbursing providers for unspecified codes. And in ICD-10-CM, they may not tolerate them at all.
For example, most superbills list ICD-9-CM code 250.00 (uncontrolled diabetes mellitus, type 2, without mention of complication) as a valid selection. However, physicians need to recognize that this highly popular code will transfer to ICD-10-CM code E11.9 (diabetes mellitus, type 2, without complications) – an unspecified code.
In this situation, payers may deny payment for insulin pumps and other services unless a more specific code is used. So, be sure to research, verify and become comfortable with the codes you’re going to use most often
The Centers for Medicare and Medicaid Services (CMS) has prepared this website covering the ICD-10 basics. The website provides a list of all the ICD-10 codes, advice on transition strategies, and contact information for CMS’ ICD-10 team.
Even though ICD-10 will likely bring some problems, it also will usher in a better method for coding. Once implemented correctly, your practice should not only be able to document and track its billing cycle better but should also receive higher, more accurate reimbursements.
