ICD-10 Testing Approach for Small Physicians

ICD-10 Testing Approach for Small PhysiciansThe United States of America is currently following the ninth edition of the International Classification of Diseases (ICD) code which is published by World Health Organization (WHO). This came into effect in 1979. Hence, it was decided to modify these codes and with conforming to the guidelines set by WHO it was decided to adopt the tenth edition of ICD; popularly known as ICD-10.

Just to put it in perspective, here are a few differences between ICD–9 and ICD–10. Where ICD–9 has about 14,000 codes ICD–10 has approximately 69,000 codes. ICD-9 has a limited scope of introducing new codes whereas in ICD–10 there is huge scope of introducing new codes. In ICD–9 has limited details embedded within codes but in ICD–10 more specific details are mentioned.

The Centre for Medicare & Medicaid Services (CMS) is collecting successful tests of handling claims which follow ICD–10. It reported that 775 physicians and providers have submitted about 9000 claims during acknowledgement testing of which 91.8% of those claims have been accepted. The final scheduled acknowledgement testing period is June 1 – 5.

Approach for Small Physicians

From the above we can understand that ICD–10 will be implemented and it is better than its predecessor. So, what are the steps that small physicians need to take to adopt ICD–10 implementation?

First of all small practices will need to plan properly. The top leadership needs to come to terms with the fact that this is a reality and it will happen. A budget needs to be prepared for the software upgrades and training needs. A timeline needs to be prepared and practices will have to stick to it.

The testing phase is quite important. One needs to find out if the process that is being implemented is producing correct results consistently or not. Testing will benefit providers by minimizing risks such as claim denials and delays which could arise due to ICD–10 coding errors.

Another aspect to consider is what to test? One needs to take in to account what tests others have done and check what their results are so that the physician can narrow down the apt test that they should do. Tests for high impact diagnosis or procedure codes having higher claims need to be checked.

The next step for testing should be with whom to carry out the test. The physician needs to contact the EHR vendor and confirm if they are ICD–10 compliant or not. Also one needs to check with the top payers if they are in sync with the new codes.

We can see that there are a lot of steps that need to be taken to ensure that a smooth transition happens from ICD–9 to ICD–10. Please share your thoughts on what other steps need to be taken for a smooth ICD-10 transition.