How to survive the ICD-10 transition if you're just starting
With less than 30 days until the ICD-10 deadline, physician practices better be ready to use ICD-10 codes. If not, get started.
With that timetable in mind, I cribbed and put into a post the Centers for Medicare and Medicaid Services (CMS) ABCs of ICD-10 preparation. There are three parts to it:
- Assess how ICD-10 will affect your practice and make a plan
- Be sure your systems are ready
- Contact your vendors
Considering I've been blogging about this for four years, that doesn't seem like a lot of work. Denny Flint, a healthcare consultant, sees advice like this as too much work. Not that he's against hard work, but there isn't enough time to do a lot of ICD-10 project planning. So he strips it down to clinical documentation training.
Even that is pretty easy in his opinion. Start dual coding patient encounters. He calls it a silver bullet. Dual coding will show where documentation falls short and give the coding staff practice with the ICD-10 code set.
Rosemarie Nelson suggests a similar quick path to ICD-10 implementation but points out something that needs to be added to Flint's advice: Focus on the most common diagnoses.
Flint also recommends dual coding at least 10 patient encounters each week. Make sure the most common diagnoses are part of that mix. If you don't have a practice management system that can run a report of common diagnoses or ICD-9 codes, the look at the superbill. Go by instinct or memory. But start coding something.
The MLN Connects Provider eNews for Sept. 3 provided links to several ICD-10 resources:
- Access the ICD-10 Code Set
- List of Valid ICD-10-CM Codes
- “General Equivalence Mappings Frequently Asked Questions” Booklet — Revised
- “ICD-10-CM/PCS ICD-10-CM/PCS Myths and Facts” Fact Sheet — Revised
- “ICD-10-CM Classification Enhancements” Fact Sheet — Revised
- “ICD-10-CM/PCS The Next Generation of Coding” Fact Sheet — Revised
- Get Ready Now: Assess How ICD-10 Will Affect Your Practice
- Prepare for ICD-10 with MLN Connects Videos
(Centers for Medicare and Medicaid Services)
- Contact your vendors
- Train your staff
- Convert your top 10-15 diagnoses to ICD-10 codes
- Prepare to watch acknowledgement reports
- Reserve cash
- Medical coder training
- Physician training
- Convert forms and templates to ICD-10 codes
- Test with payers
- Clean up your billing back logs
- Automation can boost productivity
Looks at a survey by Porter Research in August and commissioned by Navicure:
- 85 percent were optimistic they would be ready Oct. 1.
At the time of the survey, 57 percent said they were ready.
- Thus, the "shaky optimism"
- Note, other surveys found much less readiness among smaller healthcare providers.
Healthcare providers worry about:
- Cash flow
- Staff morale
- Clinical documentation
- Patient experience
- Staff productivity
- Breast cancer: Document where cancer appears in the breast and which one (left or right).
- Benign neoplasm of the colon, rectum, anus, and anal canal: Be specific about where in the colon it occurs.
- Sickle cell anemia: This is now a combination code.
- Primary liver cancer: Specify the type of liver cancer.
- Lymphoma: There will be many types of lymphoma to document as well as anatomical location.
- Malignancy in pregnancy: Coding goes beyond the neoplasm chapter. For example, you will need to document trimester.
I don't usually recommend webinars but I thought one on last minute ICD-10 tips scheduled for Sept. 22 is aptly named. (Daily Practice Blog)
- CureMD unwrapped a free training tool for physicians.
- NueMD posted ICD-10 tools that include a code-search function and training games.
- ICD-10 Charts posted free online services for converting from ICD-9 to ICD-10 and building charts with ICD-10 codes.
- 3M Health Information Systems updated its cloud-based Code Translation Tool for converting ICD-9, CPT or HCPCS codes into ICD-10 as well as normalizing reports, updating processes and educating staff.
Grab a cup of coffee before you get into this financial analysis of how ICD-10 coding will affect MS-DRG reimbursements. The bottom line is that reimbursements will drop less than 1 percent after Oct. 1. (3M HIS Blog)