Julian Knight
Dr. Rogers and Dr. Conway outlined a number of resources available to assist with the transition: • General information is available is available at the Road to ICD-10 and www.cms.gov/ICD10 • Should a problem or concern arise, turn first to your billing vendor or clearinghouse • Next, reach out to your Medicare administrative contractor (MAC) • Questions and concerns can be emailed to the ICD-10 Coordination Center at icd10@cms.hhs.gov • If there are still issues, email the ICD-10 ombudsman’s office at icd10_ombudsbman@cms.hhs.gov.
The advice from those who have already tried coding with ICD-10? Hire a certified coder if you don’t have one on staff already. Another bit of advice: Scale back on the number of patient visits you book in October. That will give extra time to learn and incorporate ICD-10 into work flows.
“To help physicians and other providers get quickly up to speed, CMS has launched the ICD-10 Clinical Concepts Series for specialties,” according to a post on the agency’s ICD-10 news website. The specialty guidebooks include: family practice, internal medicine, cardiology, ob.gyn., orthopedics, and pediatrics and can be found here.
Physicians will have a year to learn how to properly code under ICD-10 before facing potential penalties or withheld payments, according to a joint announcement from the Centers for Medicare & Medicaid Services and the AMA. During that first year Medicare will not deny claims based solely on the specificity of diagnosis codes, provided they are in the appropriate family of ICD-10 codes.
Here’s a prioritized list of what needs to get done: 1. Generate an ICD-9 frequency report, 2. Schedule training, 3. Crosswalk your common codes from ICD-9 to ICD-10, 4. Conduct a gap analysis to identify the ICD-10 terms missing from each provider’s current documentation, 5. Contact technology vendors, 6. Use completed code maps to build diagnosis code databases, EHR templates, charge tickets, pick lists, prompters, and other coding tools, 7. Schedule testing with clearinghouses and payers, and 8. Develop a plan for a potential cash flow crunch.
First, establish a sense of urgency, particularly since training coders alone can take, on average, from 6 to 9 months. Next, have a clear strategy, complete with timeline, for when goals should be met for the conversion. Most importantly, have as much support as possible from your institution’s or practice’s leadership “because one way or another, this is happening.”
In terms of financial preparation, discuss with the practice’s top payers what kind of contingency plans are needed to ensure their revenue remains sufficient after Oct. 1, said F. Phil Cartagena Jr., ICD-10 program manager for Partners Healthcare System in Boston. The general recommendation is that practices have a minimum of 3 months of cash flow on hand, Mr. Cartagena said in an interview.
I suggest you start by identifying your most-used 20 or 30 diagnosis codes, and then study in detail the differences between the ICD-9 and ICD-10 versions of theTake as much time as you need to do this: Remember, everything changes abruptly on Oct. 1, and you will have to get it right the first time.
