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Last-minute tips for ICD-10 preparedness

karen england
Karen England, Revenue Cycle Consultant, Ingenious Med

With merely a few days left until ICD-10 goes into effect, it’s safe to presume this is the home stretch for most healthcare providers, right? Wrong.

Like students cramming for last-minute exams, many providers are waiting until the 11th hour to prep and test. In fact, according to a recent poll conducted by SERMO, a social network for physicians, 71 percent of respondents said they weren’t ready for the transition.

Whether it’s a matter of limited resources or disbelief that ICD-10 is, in fact, becoming a reality, healthcare providers who aren’t ready for the transition will inevitably face revenue cycle disruptions.

However, to put things in perspective, losses in productivity from all players within the healthcare industry are expected no matter the preparedness. If you’re one of the many scrambling for ICD-10, make the most of the time you have left to curb your losses.

Check in with your software vendors

If you’re utilizing software to document the vast majority of your processes, you’re probably more prepared than you think. Most vendors have been working diligently to become ICD-10 compliant and have put measures in place to help ease the transition for their users. 

One by Ingenious Med, for example, has an automated coding system that translates thousands of ICD-9 codes and descriptions to their ICD-10 counterparts. It also offers crosswalk tools that allow patients to be converted bi-directionally and bill editing in ICD-9 and ICD-10 environments.

If you’re not sure whether or not what you use is compliant, now is the time to reach out to your technology vendors and find out their level of readiness.

Test for ICD-10 pain points

In order to make the process of unearthing what areas of your practice still use ICD-9 codes more manageable, map out workflows for only your most common diagnoses and procedures. This allows you to have a quicker understanding of what processes and systems need to be immediately readied for ICD-10. CMS suggests evaluating the following for those diagnoses and procedures:

  • Patient registration and scheduling
  • Clinical documentation/health records
  • Referrals and authorizations
  • Order entry
  • Coding
  • Billing
  • Reporting and analysis

Once you’ve identified what needs to be corrected, updates can be made accordingly. In tandem with reviewing your processes, CMS recommends testing your systems to:

  • Generate an ICD-10 ready claim
  • Perform eligibility and benefits verification
  • Schedule an office visit
  • Schedule an outpatient procedure
  • Prepare to submit quality data
  • Update a patient’s history and problems
  • Code a patient encounter

Team training and create a feedback loop

As ICD-10 requires more specificity versus ICD-9, it’s incredibly important that healthcare providers, especially physicians, are trained to complete patient documentation correctly. Fortunately, there are a multitude of resources available through the CMS and the AMA to help.

During the early transition days, mistakes are inevitable, so provide educational opportunities with feedback. Coders and billers should give immediate feedback to physicians when they get something right or when there is room for improvement in their documentation and ICD-10 code selection.

Additionally, you can select a physician champion to act as a mentor or resource for other physicians in their group. This champion can help with questions and become someone others can go to with questions during the transition.

In some instances, healthcare providers are also creating “ICD-10 command centers” to help mitigate any issues with billing or coding that might occur. More robust than a physician champion, these command centers typically consist of a team of staffers who are dedicated to monitoring, educating and handling all things ICD-10. 

All things are hard before they get easy

While the early days of the ICD-10 transition might be a bit tempestuous, ultimately the move to ICD-10 is a positive one for the healthcare industry. ICD-9 is no longer capable of keeping up with the progression of diseases or new medical procedures. With ICD-10’s increased specificity, healthcare providers reap the benefit of more accurate trend and cost analysis, which can help from a savings and care perspective. With further accessibility to detail, healthcare providers can also become more strategic in analyzing patient needs and trends.

As the saying goes, all things are hard before they get easy, and ICD-10 is no exception. However, those healthcare providers who take last-minute measures to prepare have a much smoother outlook ahead.