Starting October 1 2015 , it will be mandatory for all the provider’s offices in United States to report their patients’ diagnoses applying the new ICD-10 coding. In other words, there will be a transition from the existing ICD-9 coding to new ICD-10, which is bound to affect the revenue cycle of all physicians, lest any claims are still submitted using ICD-9 coding after the end of September this year. After the conversion date, the old codes will expectedly produce unexpected results and the medical claims carrying ICD-9 codes will not be processed due to invalid codes.
In order to get ICD-10 compliant, the first step will be to evaluate the current status and chart out a complete implementation plan. According to a survey by WEDI, only one-third of medical practitioners have completed the critical first step till now.
Timelines for the tasks in the implementation plan would need to be worked out backwards from the compliance deadline. So, the longer you take to take the first step, the tighter becomes the timelines. Not to mention, the current status would need to be appraised by executing an impact assessment and the gaps identified would need to be fixed well before the deadline. The blueprint of the plan should include budget inclusive of anticipated and unexpected costs for software, training, documentation etc. In other words, ICD-10 transition is bound to cost you a good deal and just might drive you to overspend lest your office is well-prepared for it beforehand. To elaborate, you may need to spend on aspects, including but not limited to the following: –
Software Upgradation: – You would need to assess the technology requirement for ICD-10, and consequently, either upgrade the current software or replace it with the most effective but economical of alternatives.
Training the staff: – It goes without saying that you would require a comprehensive and ongoing plan for training your staff to be well conversant with medical terminology and anatomy in terms of ICD-10 coding. To understand initial and subsequent ICD-10 codes will be critical to getting better reimbursements. The Centers for Medicare and Medicaid Services (CMS) have stated that training for clinical staff will require 8 to 16 hours. The coder will require 24 to 40 hours and 4 to 8 hours of training is estimated for the IT staff members.
Documentation: – You will also need to review current documentation and map ICD-9-CM to ICD-10-CM codes. This will clearly bring out any specific information that is missing for accurate ICD-10 coding.
A reliable impact assessment will help you know the exact changes that are pre-requisites over the changes that can be postponed for the time being for spreading the cost of ICD-10 transition over a longer period of time, and hence not disturb your revenue cycle.
Based on the estimates thus derived, it is also advisable to assess if the total cost of shifting to ICD-10 undertaken internally is more economical than outsourcing the entire process to an external agency for smooth and seamless transition, of course, without adversely affecting the revenue cycle.
MedicalBillersandCoders is a reliable outsourcing partner to many provider’s offices, helping them to prepare for and implement ICD-10 transition economically and well within compliance deadline.