5 Steps to Prepare for ICD-10 Starting Now
The panel consisted of George Kaplinkski, vice president of operations of ASC Billing Services at SourceMedical; Betty Gomez, vice president of IT operations at ZirMed; Ron Pelletier, vice president of market strategy at SourceMedical; Laurie Spinner, compliance manager of ASC Billing Services at SourceMedical; and Angie Hicks, director of product management at SourceMedical.
Mr. McDonald briefly discussed how ICD-10 will be different from the current ICD-9 system, as well as the benefits to be derived from the switchover. Though the implementation deadline for the switch over has been pushed back until Oct. 1, 2014, the panel discussed action ASC administrators and staff can take now to ease the transition.
How ICD-9 and ICD-10 differ:Practically, ICD-10 uses more characters and requires much more specific coding than its predecessor. For diagnosis codes, ICD-9 had 14,432 possible codes, while ICD-10 will have 69,368. For procedural codes, ICD-9 had only 3,859 codes, while ICD-10 will have 87,000.
Private physician practices and ASCs must use ICD-10 diagnosis codes starting Oct. 1, 2014, while inpatient hospitals must use ICD-10 procedural and diagnosis codes by the implementation deadline.
Benefits of ICD-10:Mr. McDonald noted that while many of the benefits of the switchover will favor payors and government agencies, physicians and practices will still gain some reward from the new system. Mainly, ICD-10 is a worldwide standard, and the United States will finally be in alignment with international health systems.
In addition, a greater number of codes means greater specificity and the ability to provide more detail on patient services. The government also believes the system will help prevent healthcare fraud and abuse, and health researchers will be able to track public health risks.
What can you do today?
1. Begin training. The implementation date seems far away, but Ms. Gomez explained that companies have a lot of work to do before the new system can successfully take effect, with experts estimating up to 30 hours for thorough personnel training.
Especially in the beginning, coders' daily work will be slowed, even for the most experienced coders, Ms. Spinner said. Allow coders to have more time to do the work and to double-check their codes with the manual and the software.
Also, many companies and practices will need more coders in the beginning. "There's a pretty steep learning curve," Mr. Kaplinkski said. "It will help to have the additional resources to meet that challenge when it comes in 2014."
Many companies and associations also offer training courses, both online and in person, to help coders get up to speed.
2. Start incorporating physicians. Physicians will need to provide more detailed documentation on their patient encounters once ICD-10 takes effect. If the physicians are not providing enough detail, the burden will fall on the coders to make sure billing is not affected. Work with physicians now to make them aware of the new standards and help ease the transition for the coders.
3. Talk to vendors about their transition plans. At the most basic level, your software will need to accommodate many more codes than it did previously. "The tables you work from where all the codes are stored have to be modified for the code set," Mr. Pelletier said. "You need to think about what testing your vendor is doing. Can your system performance handle that?"
The panel suggests talking to vendors and making sure that they will provide you with the updates you need to use ICD-10. "Make sure whomever your vendor is that they provide and you subscribe to an electronic code distribution service where you are getting those filed electronically," he said, adding that you do not want a staff member to be forced to input all 80,000 codes at the last minute.
Many vendors may not have begun the data transition, but inquiring about their plans will force them to begin devising a strategy and will make the overall switch smoother. "At least your vendors will know you are on the ball and interested," Ms. Gomez said.
4. Talk to commercial payors about their transition plans. While no one can know exactly how payors will handle the transition, companies can at least educate themselves on major changes before they take place. Payors may change or adapt their policies or require higher code specificity to get the maximum reimbursement.
"We'll all have to pay attention to our biggest payors and understand what those changes are and when they go into effect," Mr. Pelletier said.
5. Consider outsourcing. Some coders may not want to continue their education or take on the task of learning a new system. If your practice is looking to hire an expert to handle ICD-10 coding, begin looking into outsourcing now. Mr. McDonald suggested locking into a long-term contract with a reputable third-party company now to get a lower price. Once ICD-10 implementation occurs and providers are panicked, contracts may raise their rates to capitalize on flailing practices.
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