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ICD-10 Implementation Challenges & Taking Action

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Documentation? Training? Vendor readiness?  Coding?  Billing?  Where do I start?

There are many ICD-10 implementation challenges a medical practice faces.

• How will I properly document my medical records to support the coding and billing of the new ICD-10 coding system?

• Will my billing system be able to process ICD-9 for dates of service prior to October 1, 2014 that may need to be rebilled or followed up?

• Payor systems are supposed to be ready for ICD-10.  How will I know that the payor processed my claims correctly?

• How will my staff manage the extra work load that is inevitable during the transition period?

• How much is this going to cost me???

 

According to CMS, Providers should plan to test their ICD-10 systems early, to help ensure compliance. Beginning steps in the testing phase include:

• Internal testing of ICD-10 systems

• Coordination with payers to assess readiness

• Project plan launch by data management and IT teams

 

For providers who have not yet started to transition to ICD-10, below are actions steps to take now:

• Develop an implementation plan and communicate the new system changes to your organization, your business plan, and ensure that leadership and staff understand the extent of the effort the ICD-10 transition requires.

• Secure a budget that accounts for software upgrades/software license costs, hardware procurement, staff training costs, work flow changes during and after implementation, and contingency planning.

• Talk with your payers, billing and IT staff, and vendors to confirm their readiness status.

• Coordinate your ICD-10 transition plans among your partners and evaluate contracts with payers and vendors for policy revisions, testing timelines, and costs related to the ICD-10 transition.

• Create and maintain a timeline that identifies tasks to be completed and crucial milestones/relationships, task owners, resources needed, and estimated start and end dates.

 

Habanero, Inc. is available to assist in preparing you and your staff for ICD-10 Implementation.  Our Implementation Roadmap seminar  will guide you in developing your own customized plan for your business or practice.   If you don’t have the time or resources, our consultants can help.  Call 631.244.5661 or see our full in-house training schedule for more information.

55,000 New Diagnosis Codes with ICD-10

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ICD-9 contained 14,000 codes.  ICD-10 contains 69,000 codes!  Which code do I use?

The introduction of ICD-10 has been in the works for many years and there is a lot of information available.  In fact, the rest of the world has been using ICD-10 for years, and the United States is just now catching up.

Unlike the CPT procedure coding data set, which is controlled by the American Medical Association (AMA) and subject to copyright laws and licensing fees, the ICD-10-CM, ICD-10-PCS code sets and the ICD-10-CM official guidelines are available free of charge. (click here for official guidelines)

It’s a complicated code set, and using it is not intuitive.  It requires an understanding of anatomy and physiology, along with a clear understanding of the complex official guidelines.

The American Health Information Management Association (AHIMA) recommends training should begin no more than six months before the compliance deadline. Training varies for different organizations, but it is projected to take 16 hours for coders.  Training for medical practitioners is all about their documentation.  Providers who currently have comprehensive documentation habits will have an easier time of it than provides with poor documentation tendencies.

Habanero, Inc. has assisted large and small providers in preparing for ICD-10.  We offer a variety of overall and specialty-specific ICD-10 training to help you and your staff navigate this complex, yet vital corner of the healthcare arena.

ICD-10 Transition: Y2K will look like a child’s game

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ICD-10 will impact every area of your medical practice or billing company!

There have been so many changes put upon medical practices in recent years, from EMR, new HIPAA and HITECH privacy and security requirements, advances in medical care, payor audits, just to name a few.  You may not have appreciated just how big the transition to ICD-10 is.

Everyone covered by HIPAA must transition to ICD-10.  Your participation is not optional!

You may be thinking that codes change every year, so why is the transition to ICD-10 such a big deal?  ICD-10 codes are different from ICD-9 codes and have a completely different structure. Currently, ICD-9 codes are mostly numeric and have 3 to 5 digits. ICD-10 codes are alphanumeric and contain 3 to 7 characters. ICD-10 is more robust and descriptive and there is not a one-to-one crosswalk from ICD-9.

ICD-9 is 30 years old, it has outdated and obsolete terms, and is inconsistent with current medical practices.  It’s time for a change, and the sooner you begin, the more time you’ll have to get it right.

Habanero, Inc. has been consulting to the healthcare industry since 1996 and is poised to help your medical practice or billing company prepare for, and transition to, ICD-10.  We offer affordable training classes and consulting services.