Welcome back to this unique space dedicated to complimenting your ICD-10 specific training program with topics of primary significance to medical billing and coding professionals. During the course of this yet another interesting topic:
Blunders to avoid while ICD-10 implementation
In this discussion; we shall know:
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How the transition to ICD-10 is beset with challenges, and
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How crucial it is for you (billers and coders) to anticipate and be prepared for the likely challenges and blunders while billing and coding in the ensuing ICD-10 regime
Welcome back to this unique space dedicated to complimenting your ICD-10 specific training program with topics of primary significance to medical billing and coding professionals. During the course of this yet another interesting topic:
Blunders to avoid while ICD-10 implementation
In this discussion; we shall know:
-
How the transition to ICD-10 is beset with challenges, and
-
How crucial it is for you (billers and coders) to anticipate and be prepared for the likely challenges and blunders while billing and coding in the ensuing ICD-10 regime
Well, by now, we presume you must have realized how monumental the task of migrating to ICD-10 compliant medical billing and coding. While there can be no questioning as to your commitment to upgrading your skill sets, you may be caught unawares by certain factors when you actually start using your ICD-10 knowledge to augment your physicians’ medical billing reimbursements.
Therefore, it becomes imperative that you draw inspiration from historical experiences in foreseeing the challenges, and plan in such a way that you do not stumble in the execution. Drawn from a correlated inference from the past, here is list of blunders that you would dearly love to avoid while implementing undertaking billing and coding of your physicians’ claims under the ensuing ICD-10 regime:
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Improper usage of ICD-10 codes: Most of the problem starts with improper medical coding. Therefore, it is critical to know the importance of proper ICD-10 coding and the impact it can have on a member’s welfare. Notwithstanding the gigantic proportion of ICD-10 coding manual, it is imperative that you are well-versed in not just general but specialty-specific coding to avoid negative impact on your physicians’ medical reimbursements.
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Being too lenient on clinical documentation: Although physicians themselves attach utmost importance to clinical documentation of their investigations and medical procedures, yet there may be cases wherein physicians continue document in such a way that it may not be compliant with the HIPAA 5010 mandate. If you happen to base your coding on such clinical documentation, you could be running the danger of increased denial or delay by payers on the pretext of non-compliance with HIPAA 5O10 which facilitates ICD-10 medical billing and coding. Therefore, as billers and coders, you would be required to be not only vigilant but also help your physicians to set up technology interfaces that support HIPAA 5010 mandate for universally approved EHR practices that can be relied as the most fool-proof evidence for error-free medical coding.
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Continuing to process the claims using older technology interface: As the ICD-10 has tendency to impact human and technology processes, continuing to process the claims through older technology platforms may your physicians’ claim susceptible to undue verification and auditing, which may in turn, result either in unwanted delay or denial of the claims. Therefore, it is imperative that you fore-see these technological requisites and source amicable technology platforms from credible vendors who best match your need for customizing technology as per ICD-10 mandate.
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Believing the reimbursement environment to be as lenient as it was during ICD-9 regime: While most of you may be aware of ICD-10’s gigantic impact on medical billing and coding, yet you may still continue to be under the wrong impression that payers will be continue to be as lenient as they were in the ICD-9. But, it is not going to be. As ICD-10 arms payers with increased scope for verification and auditing, your physicians’ claims will eventually be susceptible to delays and denials. Therefore, it is imperative that you complement your billing and coding with equally capable denial management practice to augment claim realization and mitigate the chances of rejection second time around.
While these are certain indicators to the possibility of error during ICD-10 implementation, they should also act as guidelines during your actual course of action. The cognizance of these indicators in our full-pledged ICD-10 specific Training Program, – interspersed with webinars, forums, and online learning materials – will sure be an enriching experience and assist medical billers and coders in facing these challenges during actual course of action.
Watch out this space for yet another interesting topic next week: Hospital staff adapting to ICD-10…