With ICD-10 deadline extension, radiology practices now have an extra year for preparation and they should utilize this opportunity to prepare well for the transition. When the Protecting Access to Medicare Act of 2014 (PAMA) was signed on April 1, 2014, the American College of Radiology supported its various provisions, most importantly, delaying the implementation of ICD-10 provider payment codes until October 1, 2015. They were working hard to prepare radiology providers for the transition at that time. Now, they are urging the providers to take full advantage of this additional time and get fully prepared for the new set of codes.
Enhance Radiology Reports Documentation
Radiology coding for procedures and diagnoses is done separately from the written documentation prepared by the physician. Certified coders assign the codes based on what is described on the physician’s report. Thus, the accuracy of coding depends largely on the quality of documentation. So, the first step towards ICD-10 transition is to enhance the level of documentation in radiology reports. With the additional time, practices can check whether their documentation complies with the new coding system and implement the necessary modifications with immediate effect.
Conduct Gap Analysis
With the extra time available now, practices can perform gap analysis to identify the areas where documentation is adequate and where changes are needed. The documentation for ICD-10 has to be very specific compared to ICD-9. This is because of the high specificity of the codes with the new coding system. For example, there is only one code in ICD-9 for abnormal finding on antenatal screening of the mother.
- 796.5: Abnormal finding on antenatal screening
However, we can see more specific codes with ICD-10 such as:
- O28.0: Abnormal hematological finding on antenatal screening of mother
- O28.1: Abnormal biochemical finding on antenatal screening of mother
- O28.2: Abnormal cytological finding on antenatal screening of mother
- O28.3: Abnormal ultrasonic finding on antenatal screening of mother
- O28.4: Abnormal radiological finding on antenatal screening of mother
- O28.5: Abnormal chromosomal and genetic finding on antenatal screening of mother
- O28.8: Other abnormal findings on antenatal screening of mother
- O28.9: Unspecified abnormal findings on antenatal screening of mother
With the new coding system, new information regarding the patient’s condition that radiologists may not have documented before can be captured. So, providers have to update, modify and expand their documentation as per the needs and gap analysis can really reduce the efforts taken for this process.
Develop Mapping Table
There will be no need to change the documentation for some of the coding in the new system. For such cases, the timeline extension will give you breathing space to develop a mapping analyzing the most commonly used ICD-9 codes in your practice. There is also time to make this table a tool to educate physicians, coders and other staff involved in capturing patient data.
Evaluate Workflow Processes
The level of information about patients collected from referring physicians is important for good reporting and the role of complete and comprehensive information is more critical in the new coding system since most of the coding is done on the basis of the circumstances surrounding a patient’s condition. Practices need to evaluate their workflow process to make sure that this kind of information is effectively gathered from the physician. As this will often be a function of the patient registration department, practices can utilize the additional time to modify the intake systems with additional collection and train the staff working in these areas. In the case of a hospital system, this will require cooperation from various areas that collect patient registration forms, and therefore more time.
Prepare Well to Manage Future Payment Reduction
Experts point out that when ICD-10 gets implemented, the reimbursement process will be significantly time-consuming as referring physicians will have to provide more detailed information, the radiologists will have to use greater detail in their reports, the coders will need to master the new coding systems and therefore providers should prepare well for a payment slowdown with unpredictable magnitude and duration. So, practices should focus on their finances as well and adopt measures to manage their revenue cycle effectively to address the payment reduction that may come in future.