Is Your Medical Billing and Documentation Ready For ICD-10
The date to switch to ICD-10 is fast approaching U.S. Health Care industries. The implementation will mark the first significant change in medical billing and coding in nearly 35 years. Due to the mandates of the Health Insurance Portability and Accountability Act of 1996, the migration from ICD-9 to ICD-10 is not an option. All entities that utilize health care information containing diagnosis or inpatient procedure codes must comply. What that stated, are you ready for ICD 10?
Why the Need for ICD10?
There are two significant problems with ICD-9. First, the classification system in ICD-9 is not up-to-date with modern medical treatments and technology. This makes it extremely difficult for claims to be processed fairly. In many cases, remarkably different procedures are logged in under the same ICD-9 code.
All entities that utilize health care information containing diagnosis or inpatient procedure codes must comply.
Secondly, measuring the quality of the care that patients receive is tremendously difficult using the ICD-9 system. This makes the current health care system stagnant in some ways. Without a quality measuring system in place, it is extraordinarily hard to track and learn from trending public health issues, improve medical research, and prevent payment and billing fraud.
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- Implementation Phases
- ICD-10 Assessment
- Customized Training
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Small to medium medical practices are encouraged to engage in the necessary steps to make the switch to ICD-10. The Center for Medicare and Medicaid Services recommends that health care agents follow a detailed timeline to ensure that they are ready to reach compliance by October 1, 2014. The six stages of implantation are discussed below:
- Planning - After establishing a detailed timeline specific to a practice, it is beneficial to make sure that upper management comprehends its role in the ICD 10 transition. Key personnel must absorb leadership roles for each stage of implementation. Lastly, a fiscally viable budget should be constructed with well-defined limits for each phase.
- Communication & Awareness -All key personnel members must maintain a high level of transparency in their activity to enact the ICD 10 transition. Open communication between phase leaders should also passed down to staff so that a general awareness of the practice's strategy is known. Management would do well to have regular evaluations of communication.
- Assessment - Several business process and documents will be affected by the transition. A comprehensive assessment of each operation (and the impact of the migration) should be accounted for. Any gaps in the assessment will cause long term problems in the future, therefore, a meticulous attention to detail must be exercised.
- Operational Implementation - Usually after the assessment is complete, practice management elects to have a private vendor to help the operational implementation to be put in place. IT systems, educational resources and other specialized operational tools handled by vendors should be monitored by management to verify ICD 10 compliance.
- Testing - Processes and systems that do not meet standards for ICD 10 are useless. To prevent such situations from happening testing is in order. Whether technology or staff procedure, adequate testing will reveal what works and what does not. After individual tests are performed an end-to-end test should occur. An end-to-end test will review how systems and procedures interact and flow to produce the desired outcome.
- Transition - This final phase puts the proposed and tested elements in practice. Staff and management should shed the ICD-9 system for good and move whole-heartedly to ICD 10. If any small complication occurs, it will be reviewed immediately to make sure that details of the new system are being followed. If there is a problem with the new system, management will modify the error to prevent gaps in successful operations.
The time to prepare is now. Would your practice benefit from ICD-10 Training from a AHIMA ICD-10 Ambassador Approved Trainer? Do you need an ICD-10 Assessment? We have noticed that a large percentage of today's documentation is not ready for the ICD-10 transition. ICD-10 codes required more specificity than ICD-9 codes.
- Review and provide report of up to 10 pre-training chart notes to assess your current documentation in preparation for ICD-10.
- Subsequently we will identify any deficiencies and develop training tools that will be required to assist us in the education needed to improve documentation.
- Your specialty specific training will provide conventions needed for ICD-10.
- After training, we will review up to 10 post-training chart notes.
- This customized program will result in documentation that will help your practice avoid denied claims thereby reducing the risk of breaks in your revenue cycle.
- Contact us to discuss this training program. CEU available from AHIMA.