Like it or not, ICD-10 – and the 141,000 codes it will use to replace ICD-9’s mere 17,000 – is an impending force to be reckoned with. The healthcare industry has done a hefty amount of fighting to postpone, delay, or otherwise mitigate the effects of the shift to the new coding methodology, including lobbying for the new bill calling for a “grace period” against ICD-10 code-related denials. But the new system is coming down the pike regardless. How ready is your practice?
If you’re lagging behind, you may be tempted to think that the transition will require little more than sending your coders off to a day or two of training and testing claims transmission with your payers. Unfortunately, however, it’s far past the time to banish that mindset. ICD-10 will affect every single employee in your practice, so your entire staff is going to need to get familiar with the new system.
Plus, the move to ICD-10 will require you and your staff to do more than take on new knowledge and help out with testing. Failing to properly prepare for ICD-10 can be disastrous – especially if you put off planning any longer – so it’s crucial to make a game plan that considers each of the following.
Documentation
ICD-10’s codes are designed for far, far greater specificity than those of ICD-9. (That’s why there’s so many!) In order for your coders to have all of the information necessary to select the proper codes, your providers will need to furnish them with highly detailed documentation for each and every encounter.
Audit old charts to see if their documentation has enough detail to be properly ‘codeable’ in ICD-10. If you see recurring problems, conduct practice documentation-to-coding exercises with your physicians. Your docs probably won’t be happy about changing their documentation habits, but if they don’t they’ll stall the productivity of your entire back office.
Workflow Management
In fact, you should plan ahead for a productivity slowdown altogether once you flip the switch to ICD-10. Even if payer testing goes swimmingly and every member of your staff gets trained on the new code set, there’s no way you’ll operate at maximum efficiency in the midst of the big change. The best way to mitigate problems is to assess your operational workflows to make sure they’re optimized for ICD-10.
Make sure you have enough staff to cover for overwhelmed billers and coders who may struggle with the transition. Build time into each day where coders can address providers with questions so that no specificity concerns fall through the cracks and lead to improper coding. If necessary, plan to reduce patient visits during the first few weeks of ICD-10 to ease your way into the new reality.
Financial Planning
Of course, reduced productivity and reduced patient visits reap the unfortunate consequence of reduced income. The key is to accept well ahead of time that your finances may take a small hit during the transition period and to accommodate appropriately.
First, plan for the added expenses of training, testing, and any technology purchases. Then, identify what cash reserves may be necessary to cover for probable losses productivity and revenue; establish a line of credit if necessary. Trim the fat by cutting costs where you can – it’ll keep you from panicking if there’s a major hit to your cash flow. Lastly, perform the cost-benefit analysis of working with an experienced medical billing company. Outsourcing to a firm that already has the ICD-10 set down pat can be a good way to protect your practices financial performance.
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