Dual Coding - Burden or an Advantage?

Everyone in the health industry is now ready to face the ballgame that sets out on October 1. Whether it makes you happy or not, it is an established fact that ICD-10 is here to stay, leaving ICD-9 to be a thing of the past. However, this may not be the case for a while. A period has been granted wherein use of both coding systems will be necessary.

Code set to be used will depend on the date of the rendered service. Claims bearing the date prior to October 1 will be coded using ICD-9 whereas claims date October 1 or later will use ICD-10. Use of more than one code set in a single claim will not be accepted by the CMS so there could be situations where the claim may have to be split.

Advantages of dual coding

• Identifying revenue challenges
  Dual coding will assist with the understanding of your practice’s financial modeling. Detecting potential revenue changes will allow your practice to accurately prepare budgets and accompanying strategies.
• Preparation for ICD-10
  Early ICD-10 coding comes with the opportunity to review documentation for the required specificity and problems at this stage can be identified and resolved.
• Enhanced coder productivity
  Using both the code sets will make the coder familiar with new coding system and will increase his understanding and speed.
• Documentation shortcomings
  The most important advantage is that coders can identify shortcomings in documentation.

Disadvantages of dual coding

• Increased costs
  The above necessity gives rise the need for billing systems to be able to accommodate both, ICD-9 and ICD-10 at the same time which could probably turn out to be an expensive affair.
• Reduced Productivity
  For some dual coding may seem as an added task decreasing productivity and having the need to assign extra resources.
• Volume as a challenge- The sheer volumes of accounts to be dual coded may initially seem to be a challenge.

A closer look at your claims history will help you understand how long a typical claim is open based on which you can gauge the amount of time you need to use both the code sets. It is vital that you streamline processes such as turnaround time for submitting claims and denial strategy.

This will enable you to reduce on the amount of time your practice has to use both the codes. This will also ensure smooth cash flow during the transition phase. Planning for dual coding well in advance will prepare you in setting implementation goals in a cost effective way.

FAQs

Why is dual coding necessary during the ICD-10 transition?

Dual coding is required because claims with service dates before October 1 must use ICD-9, while claims on or after October 1 must use ICD-10. This helps maintain accuracy and compliance.

Can both ICD-9 and ICD-10 codes be used in a single claim?

No. CMS does not allow the use of both ICD-9 and ICD-10 codes in the same claim. Claims must be split if they span the transition date.

What are the benefits of dual coding for medical practices?

Dual coding helps identify documentation gaps, improves coder familiarity with ICD-10, reveals potential revenue impacts, and ensures smoother financial planning.

What challenges can arise from dual coding?

Challenges include increased system costs, reduced coder productivity, and managing large volumes of dual-coded claims during the transition.

How can practices streamline the dual coding transition?

By reviewing claims history, improving documentation, and planning for efficient workflows, practices can reduce the dual coding period and maintain cash flow stability.