Keep your practice upadted and do not wait for another ICD-10 deadline shift

Since the news roll out of Sustainable Growth Rate (SGR) being passed without any ICD-10 delay, medical practices are working hard to accommodate the new code set. But before the transition how successful are providers in testing?

According to a survey by American Health Information Management Association (AHIMA), many providers have not conducted ICD-10 testing. Some critical findings of the survey noted are:

• 50% of respondents said they have conducted testing with payers and clearing houses
• 34% responded said they finished all internal testing
• And only 17% said they have finished all external testing

How tough it will be for a medical practice?

Devin Jopp, president and CEO of WEDI in a letter to health and human services(HHS) Secretary Sylvia Mathews Burwell quoted, “Unless all industry segments take the initiative to make a dedicated effort and move forward with their implementation work, there will be significant disruption on Oct. 1, 2015”

Many medical practices did not leverage the 1 year time due to the delay. With only 69 days left for the deadline, practices will be in a rush to train their staff, get a certified coder and the effort required to get your vendor ICD-10 ready will certainly impact their bottom-line.

6 Steps your practice needs to take today!

1. Have you sent those prior authorization requests?

The written approval that a physician needs from payors for prior authorizing medical procedures can take enormous amount of time to obtain. Create new planning forms, prior authorization letter templates and ICD-10 friendly processes.

2.The Dual code and mapping…

Dual coding and mapping out crosswalks between ICD9 and 10 can make your transition easy. It will give ample time for coders to get a hang of the new codes while ensuring the current billing cycle is not negatively impacted by the new set of codes. Discuss with payers, clearinghouses and most importantly to your EMR vendor about ICD10 testing plans.

3. Effective training and planning!             

Gulp ! There are 55,000 more codes and pretty shockingly, codes for macaw bites and skis on fire. But you are not going to use all the codes. Draw a list of all the medical codes used in your specialty and medical practice. Prepare a budget based on the codes you are going to use. Train your team in the codes used in your specialty as a one size fits all ICD10 training program won’t be of much benefit.

4.Your points of contact..

You need to prepare and develop a coding plan for all points of code contact. It includes laboratory or imaging orders, medical billing, claims transmission, clearinghouse transmissions, ERAs etc. It is not just your coding process that is going to undergo change but your entire revenue cycle. Ensure that all aspects of your revenue cycle that are going to be impacted by ICD10 are ready for the transition, not just your coding system alone.

5.Check with your vendor now!

 It is essential that your systems and processes are upgraded to accommodate the new coding family. Ensure your EMR vendor is ICD10 ready, much before you are!

6.Do you still trust your PMS to adjust the new codes set?

ICD-10 comes with higher specificity and thus the demand for data management gets higher. It is essential to make sure your practice management software has the capacity to deal with these code sets. With that said the accuracy of input can impact even the best software, so it is critical to ensure that your biller is rained well and up-to-date with the codes, not just this year but in the coming years.