ICD-10 – It’s Really Going to Happen!

 In Articles, ICD-10, Provider Notes

The SGR fix was passed by the House on March 26, 2015 without a delay for ICD-10 implementation and is expected to be approved by the Senate once they return from April recess. So, now what? Well, if you haven’t started your preparations for the transition on October 1, 2015 there’s still time to protect your practice against significant revenue delay and loss.

The first step is to determine if your vendors are ready. Can your EMR and practice management system handle the extended ICD-10 code length? Will your software need an upgrade? If so, when will you get it? Is there a cost for the upgrade? If you have an interface between your EMR and PM system, you should be testing this interface with ICD-10 codes to be sure the codes sent are the codes received. Many vendors have their ICD-10 progress posted in a public area. Take a look at their resources and start asking questions.

Next, contact your clearinghouse. This is a critical component to confirm claims submission will continue. Can they submit claims containing ICD-10 codes? Have they tested with any of the payers? If so, what was the result? Your practice management system may offer assistance with your clearinghouse readiness.

Speaking of testing, CMS allows for acknowledgement testing at any time. See here. In addition to acknowledgement, testing two more end-to-end testing weeks will be held before the October 1 ICD-10 compliance date: April 27 through May 1 – Volunteers have been selected, and July 20 through July 24 – Volunteer forms were made available on March 13 on the MAC and CEDI.

Lastly, training for physicians and staff is key to a successful transition. You should schedule ongoing training for physicians and other key personnel. The training should be role-specific and build upon knowledge with each training session. Be sure to incorporate any vendor updates into training sessions so physicians and staff won’t be surprised by new drop-down boxes or other technology changes.

Physician training should include a list of commonly used ICD-9 codes. You should identify your practice’s most-used and highest revenue-producing codes. Crosswalk the diagnosis codes for ICD-9 to ICD-10. The providers should understand that additional documentation may be required for coding to the highest level of specificity.

If you haven’t started your march toward ICD-10 transition or if you have fallen behind, use the wealth of complimentary resources available to help you prepare. CMS has a fantastic resource available online. Check your medical specialty’s association for resources that are tailored to the codes you use most and collaborate with other practices.

For additional help with ICD-10, contact Amy Dunatov at 919.442.1100 or a.dunatov@msochealth.com.

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