ICD-10 Transition: Maybe it's time to panic a little
We are about 14 months away from the ICD-10 implementation deadline. Surveys report that healthcare providers are in various states of readiness.
QualiTest Group surveyed more than 300 professionals about their ICD-10 testing plans. The two major findings are:
- Most respondents have either completed ICD-10 assessments or are in the process of assessments.
- 75 percent of respondents have not yet begun ICD-10 testing.
While starting sooner than later is important, this survey doesn't raise too many alarm bells. It does report a great deal of planning and progress in the ICD-10 transition. Other surveys released in the past few months have found less preparation.
Perhaps a more troubling indicator is the amount of newly released literature that suggests there is an audience that hasn't heard of ICD-10 implementation. If the healthcare industry is on its way to a smooth ICD-10 transition, we wouldn't need so many guides to planning ICD-10 implementation.
Seriously. That's so 2012.
The latest example I found is the white paper ICD-10: The Top 10 Things You Need To Do NOW from the medical billing firm MediGain. They advise:
- "Set up a team and appoint a leader."
- "Evaluate current software systems and office procedures in which you use ICD-10."
- "Pinpoint possible changes to your workflow and office processes."
- "Communicate with your payers about any modifications that need to be made to your contracts due to ICD-10."
- "Think about training efforts and costs."
- "Converse with your trading partners."
- "Test with your trading partners."
- "Survey your current PM vendor."
- "Assess your internal office systems and functions."
- "Revise and account for any plan adjustments."
Healthcare providers should have completed half those steps by now.
If not, then they should download the MediGain white paper. It's actually a pretty good document to start. The more detailed ICD10 Watch Implementation Timeline will help explain what needs to be done.
- Robert M. Tennant, MA, Senior Policy Advisor at the Medical Group Management Association (MGMA), can't figure out why CMS won't conduct end-to-end testing.
- Before the HIPAA 5010 transition, National Days of Testing were very helpful.
- Healthcare payers need to test more than if they can accept ICD-10 codes. They need to see how their payment policies will be affected.
- Clearinghouses report 20 percent of their clients are still using HIPAA 4010 — which cannot handle ICD-10 codes.
- Tennant worries that state Medicaid agences won't be ready for ICD-10 implementation so healthcare providers will need to use dual coding practices to get reimbursed.
- Healthcare providers need to start practicing assigning ICD-10 codes to medical claims.
- Expect delays in reimbursements after Oct. 1, 2014.
- Hoard enough cash to cover three to six months of operational expenses.
- Talk to banks now when you don't need it.
- Ask healthcare payers about contingency plans.
Increasing Revenue and Planning for ICD-10: How Clinical Documentation Improvement Accomplishes Both
Mel Tully, senior vice president of clinical service and education at technology firm Nuance, has three tips:
- Improve documentation now for ICD-9 coding.
- Analyze the DRGs and procedure codes that account for most of your revenue.
- Medical coders should start clarifications and queries now for information that supports ICD-10 coding.
Bonnie Cassidy writes about why healthcare providers need to consider dual coding:
- It will require time and effort but should be worth it.
There are risks by not dual coding:
- Not assigning the right ICD-10 codes.
- Losing revenue.
- Increasing claim denial and audits.
- Medical coders will gain practice.
- ICD-10 transition team can assess its education and training programs.
- Will you conduct external testing?
- Will you be dual processing, and if so, when will you start?
- What will happen if something goes wrong?
Barbara Aubry sings the praises of specificity. (3M Health Information Systems)
CMS has released the final update for the ICD-9-CM code set. It goes in effect Oct. 1. (Centers for Medicare & Medicaid Services)