Medical Billing Tip: Keep Your Practice on Track for ICD 10

September 23, 2014 by Antonio Arias, MBA, CHBME

Topics: Medical Billing

Now that the Department of Health and Human Services has pushed the ICD 10 compliance deadline to October 1, 2015, your practice’s ICD 10 implementation plan might be the furthest thing from your mind. But while you don’t need to be in a mad rush to make intensive ICD 10 arrangements, it’s important that you stay on pace to adopt the new coding standards with minimal disruption to your business.

The switch to ICD 10 will consume a lot of  hours around your office for staff education and technology upgrades. Maybe before the latest postponement was announced on July 31st, you had started preparing for the changes… or maybe not. Either way, you should use the extra time wisely. Take these steps to keep your practice on track.

Get Educated: You know what ICD 10 is, but do you know how it will impact your particular specialty? Diagnosis mapping will be highly convoluted for some practices depending on the codes they use most.

According to a report from the American Medical Informatics Association, obstetrics, psychiatry, and emergency medicine practitioners will face more challenging transitions than hematology, oncology, and primary care providers. Figure out how your specialty will be impacted and make sure your coding team knows what to expect.

Set Your Budget: The latest estimates from the American Medical Association put the cost of ICD 10 implementation anywhere between $56,639 and $226,105 for a small practice. (Large practices could be out as much as $8 million!) Have you considered where the necessary cash will come from?

Ideally you’ve already laid out your budget for software purchases and implementation fees, but be sure to incorporate employee training expenses and testing costs.

Consider Staffing: There may be a spike in claim denials when the ICD 10 standards take effect. Medicare has yet to conduct end-to-end testing on claim submission and adjudication but has done some initial “acknowledgment testing,” finding only 89 percent of test claims accepted without issue compared to normal acceptance rates around 95-98 percent.

Does your team have the manpower and expertise to handle an increase in denials and resubmissions? Think ahead about your hiring needs – experienced coders and billers will be hot commodities come 2015. Or, consider contracting with a medical billing company to avoid productivity lags or payment delays.

Make a Testing Plan: Once your software is ICD 10 ready, you’ll need to do your own testing with clearinghouses and payers to make sure you don’t experience technical glitches. It may be too early for you to do that, but you must make a timeline to ensure testing doesn’t fall off your to-do list.

Contact your technology partners now to set definitive times for testing. Even if the dates are as far out as next summer, having them on your calendar will keep you accountable to be testing-ready when the time comes.

Review, Revisit, Reevaluate: The shift to ICD 10 will be a major change for your practice, no matter your size, specialty, or current preparedness level. Take some time to review your current office processes and determine how they’ll need to change to support ICD 10.

The Centers for Medicare & Medicaid Services can help with that. CMS created a ‘Road to 10’ resource center to help providers understand what they’re in for with ICD 10, and it includes a library of webcasts, reference materials, and templates for physicians and staff.  Road to 10 features a tool enabling practices build individualized ICD 10 action plans. Create yours to learn what changes you may need to make.

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