With the required implementation of ICD-10 on the horizon, many hospitals, medical facilities and private practices are struggling to make the necessary changes to meet the new standards. While the changes from ICD-9 to ICD-10 may seem varied and complex, the transition need not be a worrisome struggle. It can instead be a rather seamless transition with a few practice management suggestions to help meet the Oct. 1, 2015 implementation deadline.
Awareness of Coding Changes
Being aware of two major coding changes can be the first step in effectively implementing them. The federal Medicaid website reports they are:
- Expansion of code set: Code sets in ICD-10 consist of seven positions, with each position supporting alphanumeric characters. ICD-9 had only five positions, with only the first position open to alphanumeric characters.
- Increase in number of codes: The number of ICD-10 codes is 68,000 in ICD-10, a substantial increase over the 13,000 codes in ICD-9.
Although ICD-10 cannot be put into active practice until its official Oct. 1, 2015 implementation date, starting the transition as early as possible is crucial step for an effective transition. It gives organizations the opportunity to troubleshoot any issues while ensuring they are not placed on a long vendor waiting list. Vendors specializing in practice management software and electronic health records are likely to be in high demand, which makes early preparation an essential strategy.
Learning the Most Common Codes
Attempting to learn the entire slate of new codes may be impossible as well as unnecessary. Many healthcare professionals may have a handful of codes they consistently use as part of their practice. Making a list of the most common 20 to 25 codes from ICD-9 and then learning the ICD-10 equivalent can be incredibly helpful, especially in the early phases of the transition. Specific hospital or medical facility departments can use the same strategy, focusing on the most common codes needed for effective practice management.
Identifying Gaps in Descriptors
The new coding system demands greater detail in the way of descriptors, and failing to use them could result in the denial of claims. One way to spot check the attention to detail that will be required is to review existing charts and find any gaps that may occur between the new and old coding systems.
Organizations may examine the existing ICD-9 codes used in the charts then match them up with the equivalent ICD-10 codes, taking note of the key words present in the code descriptions. They can analyze the differences by checking how many claims using ICD-9 would be rejected under ICD-10. This can be a vital learning experience for physicians and staff, illustrating the importance of paying acute attention to the additional detail required.
Ascertaining Vendor and Payer Readiness
Even if a hospital, medical facility or private practice has properly prepared itself for the transition, nothing is likely to go smoothly if the facility’s vendors and payers are not equally as prepared. Organizations would do well to inquire about their vendors and payers readiness to embrace the new system. Key inquiries may include:
- If electronic health record vendors will have revised templates ready
- The type of testing vendors are undergoing to ensure an efficient transition
One more key fact that may help with transition from ICD-9 to ICD-10 is to remember the overall goal. Regardless of the extra work the ICD-10 transition may be causing in the short-term, the changes were made to ultimately make the billing process more accurate, detailed and reflective of the changes made in the world of medicine over the past 25 years.