Revenue Cycle Management Blog | GroupOne Health Source

4 Steps to Help You Trump ICD-10

Written by Kaitlyn Houseman | April 29, 2014

If you have not heard by now, CMS has delayed ICD-10 implementation until October 2015. The delay either has you annoyed, doing a happy dance, or perhaps both.  Already start your ICD-10 implementation phase?  If so, it is crucial not to lose the ICD-10 momentum.  If you have not implemented a plan yet, you are in luck!  However the luck will run out so it is important that you take steps to prepare for the ICD-10 implementation.  The thought of the switch alone is stressful but procrastination will only make the transition more difficult.

Now that there is extra time to prepare for ICD-10 implementation there is no excuse to not be 100% on track with ICD-10.  Start preparing with these 4 simple steps for success.

Identify how ICD-10 will affect your practice

How will the code switch affect your authorization/referrals, nursing staff, and most importantly your billing staff

This extra time allows for added education to these departments. Ask all staff members how/where they use or see ICD-9 in order to prepare them for ICD-10. Perfect your knowledge of this transition by reviewing ICD-10 resources from CMS, trade associations, payers, and vendors. Inform your staff/colleagues about the upcoming changes.  Coders can begin dual coding notes for practice. If your coders are certified, they have more time to prepare for their certification requirements. 

Begin provider documentation training

Remember the old saying “if it wasn’t documented, it wasn’t done”, this holds especially true with ICD-10.  The new codes are far more descriptive and complex than ICD-9.  There are no longer any unspecified codes.  The more descript in documentation, the easier it is to determine the correct code.  One way to improve documentation to ensure it is ICD-10 ready is to audit sample progress notes to show where documentation is lacking. Identify the common ICD-9 codes used and educate staff on the new ICD-10 codes.

Create a plan of attack for October 2015

Contact your payers and vendors—software/systems, clearinghouses, billing services—about ICD-10 readiness.  Contact your payors to determine what their plan is, are they ready?  What will you do if your claims deny?  How soon will you follow up on these?  The last thing you want is for these claims to resort to a timely filing status for lack of follow-up.

Review your trading partner agreements with your service providers and your software providers.  Ask about system changes, timeline, costs, and testing plans for each.

Worst Case Scenario

Since ICD-10 has been delayed for one year, use this extra time to create a revenue safety bank.   If in the event that payors aren’t ready October 2015, the safety bank will help to avoid panic if your claims start to deny and your cash flow suffers.

Despite being given a three-year reprieve on implementation, many organizations have still failed to implement an ICD-10 transition plan. It’s important that you don’t underestimate the impact this change will have on your practice. Last minute changes and failure to prepare can lead to chaos and a loss of revenue at your practice. Start preparing today by staying focused on the goal and don’t lose your motivation.