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How to Welcome ICD-10 Medical Coding

by | Sep 30, 2015 | Medical Coding News, Resources | 0 comments

ICD-10The long awaited ICD-10 Implementation has now arrived. The coding aspect of any practice is usually resource sapping, and that’s because there is a significant amount of effort and attention to detail required in assigning the right codes. That is more so when it comes to ICD-10 medical coding. Preparing for ICD-10 documentation is something your practice and others would have already thought of, since the October 1, 2015 deadline for ICD-10 implementation is very close.

Not to Panic over ICD-10 Medical Coding

However, there is nothing to be unnecessarily fearful of, because panic could cause trouble. For one, CMS has provided extensive guidelines on the transition. The new codes are easily available and AAPC also has an online code translator, while other conversion tools are also available. So you know the codes to be entered, it’s just that the procedures need to be in place.

Carrying out CDI as Deadline Approaches

With the deadline just a few weeks away, it is important that physician practices prepare for it and have contingency plans in place. Here are some practical tips suggested by the experts:

CDI (clinical documentation improvement) is important if your practice must be prepared for the implementation of ICD-10. That’s where CDI testing works, according to Robert Tennant of the Medical Group Management Association (MGMA). Even if practices have not updated their software, CDI testing can be done.

Sampling High Value Claims

Sampling high value claims could be the way to improve the documentation:

  • Tennant suggests that practices test the clarity and granularity of their documentation by sampling 25 to 30 claims, particularly the high value and high volume ones. Larger practices could sample 50 to 100 claims.
  • Then they need to check the documentation to see if they can assign an appropriate granularity for an ICD-10 code. If there are inadequacies, they must spot them and educate physicians and clinicians on improving them. Seamless transition demands precise medical coding, and this procedure will help your staff know the areas to improve and make the required changes.

Creating ICD-10 Subsets

Creating ICD-10 subsets can also help make clinical documentation more efficient:

  • While you’re developing claims, a subset of those claims must be created and ICD-9 and ICD-10 codes must be assigned.
  • Gaps in the documentation must be identified which could prevent the right ICD-10 code from being assigned by a downstream coder. The clinical documentation must be specific and complete which will enable an ICD-10 high level code to be assigned. This would help your practice make the transition smoother and also keep it from losing money.
  • Lack of sufficient supporting documentation would mean that you will have to enter a lower value code which would also result in lower compensation and revenue.

Syncing Billing Software with ICD-10 Codes

The other challenge for practices is obviously the costs involved in syncing the existing billing software with the ICD-10 codes. Their EHR system will need to be upgraded before October 1. In a survey conducted by MGMA in February 2015, 40% of respondent practices had included the cost of upgrading or replacing their EHR and billing software in their maintenance agreement, while the rest did not. This arrangement significantly helps save costs which would otherwise be incurred which, according to Tennant, would be in the region of 25 million dollars in terms of software costs.

Let’s hope these tips should help your practice prepare for ICD-10 medical coding in a reasonably efficient manner.