The U.S. healthcare industry will move to a new coding system, ICD-10-CM, on October 1, 2014. The scope and complexity of this transition are very different from the transitioning to ICD-9-CM which was implemented 30 years ago when codes and coded data were not as frequently used as they are today.
There are about 68,000 codes involved in ICD-10-CM compared to 13,000 codes in ICD-9-CM. Welcome changes include fewer codes for specialties, the use of simplified terminology, and one code instead of two for complex conditions.
But now the big question is: is your practice prepared for the transition to ICD-10-CM? Compliance is necessary to prevent claim rejections and payment delays. Only organizations that can effect a smooth transition to the new coding system by the compliance date can fully realize its benefits.
Here are the main factors necessary for a smooth and successful transition:
- Updating of coder skills: As coders need to have in-depth knowledge about anatomy and pathophysiology to deal with the clinical nature of ICD-10-CM, the American Academy of Professional Coders (AAPC) has suggested that coders take a refresher course. In addition, AAPC says that they should update their computer skills to deal with possible technological changes under the new codes.
- More specific documentation by physicians: Physicians should provide the information that coders need. This is possible with more specific documentation. Coders and physicians should examine the current system of documenting chart and see whether it is possible to code the chart notes through ICD-10-CM. If the documentation is not adequate for ICD-10 coding, they have to identify the changes that need to be made. Unspecified codes should not be used. The best place to start is with the codes that are most frequently used by the physician.
- Prepare practice staff: In a small practice, the staff needs sufficient time to make the coding transition and needs to be trained on the actual use of ICD-10 and coding guidelines. The services of a coding expert may be necessary to accomplish this.
The anticipated benefits of ICD-10 include superior data quality, improved ability to evaluate the efficiency of patient care, greater benefits from electronic record adoption, decreased costs of claims submission and claims adjudication fewer rejected and miscoded claims, all leading to increased productivity and higher revenue.
A professional medical billing and coding company can help you realize all these benefits. With a team of coding specialists who are up-to-date on ICD-10-CM coding requirements and associated billing practices, the right medical billing service provider can help maintain the financial health of your practice.