September 25, 2015
If you have not even started ICD-10 implementation, all hope is not lost! Read more to discover how to become an ICD-10 champion.
ICD-10 is just around the corner, with less than a month away. If you have not even started ICD-10 implementation, it may seem like a lost cause. While there is no denying that the implementation at this stage will be challenging, all hope is not lost! To make it through you’ll have to fight your way through it, as a team determined to take the trophy home. Follow the steps outlined below and your implementation will be taken care of.
Lead the way
ICD-10 is not a one man show; it’s a team effort with a coach, players with their extraneous training, cheerleaders and morale boosters, all with a single goal in mind of “SUCCESSFUL IMPLEMENTATION”. The “coach” needs to be on his toes to ensure he leads the way for his clinical and administrative staff in implementing this change. It has to be a collaborative effort on everyone’s part, where each person has to bring his expertise to the table.
Start off with appointing a project manager who has proven leadership skills and reliability. This person needs to have an in-depth knowledge of what ICD-10 entails and should be motivated enough to lead the team from darkness into light. The project manager needs to then bring everyone on the same page and hold meetings to ensure everyone is giving their best, while educating on ICD-10 conventions, keeping the morale up and resolving any conflicts which may arise.
Gather your supplies
With ICD, your documentation will need serious reworking! With a tremendous increase in codes, you would have to adjust it in order to capture the greater detail needed for coding. Hence, it’s imperative that you make an implementation check list of all the things that will take a hit.
• Electronic Health Records
• Practice Management Software
• Reports and Documentation
Gather up your resources and be proactive! You’ll face various situations where your program commander will have to spearhead ICD-10 implementation efforts. For example, instead of relying on vendors and payers to provide timelines, they should take charge and build their own schedules, assign objectives and set milestones to achieve.
Train a lot… and then train a bit more
Becoming a champion is a no brainer; it has no hidden secrets or shortcuts. All it requires is practice, and sheer hard work to keep trying until one succeeds. The same is applicable in Healthcare as well. The training needs to be implemented gradually in small, subtle steps. Don’t overwhelm your staff with all at once; that might just demotivate them or they wouldn’t be able to retain the information in the long run.
Also, avoid the pitfall that the CMS grace period will save you. The first truth is, this grace period only applies to Medicare claims, not private payer claims. The second truth is, you are still required to, at the very least, use a valid code when it comes to the correct family of codes. In other words, if you don’t get ANY of the codes right, there is a flag on the play and your claim WILL be denied.
The best way to combat this issue is to start thinking like an ICD-10 coder now. You should also start documenting as many specifics as you can now to get great at supporting the new codes.
Various training resources are available online in the form of training webinars, white papers, e-books, podcasts, etc. Read this Complete ICD-10 training guide to come up to speed within days.
Take stance and Fight
It is important to perform test runs before you enter this whole new terrain of codes in production. Make sure you speak with your vendors to determine their testing processes and time frames. Conduct both internal and external testing with your staff and outside partners to get familiar with the system before Oct 1st.Here’s what you can do even if your system isn’t ready for ICD-10:
• Look out for volume of conditions that constitute the major chunk of your revenue
• Look at recent medical records for patients with these conditions and try coding them in ICD-10 for practice
• Create a checklist for clinicians in cases of inadequate documentation
Your staff’s productivity will also suffer owing to the transition involved; be proactive and anticipate the challenges faced and be prepared to overcome them.
Always have a Plan B
Keep a contingency plan in mind to submit claims in case your system isn’t ready by Oct 1st.
For Medicare providers, options include:
• Free billing software available from every MAC website
• Part B claims submission by online provider portal (in about ½ of MAC jurisdictions)
• Paper claims for providers who meet Administrative Simplification
• Compliance Act Waiver requirements
• Each of these options requires you to code in ICD-10
Also, maintain an alternate line of credit for unexpected interruptions/delays in claim processing and reimbursements.
Various vendors have an all-in-one platform which integrates EHR with practice management, billing services and much more. Their services can further help you in your journey to implement ICD-10. Remember, it’s not over until it’s over.
Rejoice on your victory
Voila! You’ve become a champion. But, remember, this is just the beginning, it doesn’t stop here. You need to continuously monitor activities to ensure that the change has been fully implemented and reinforced. Conduct audits of ICD-10 coding to ensure that best possible codes are being used and payments being received.