Failing to Prepare for ICD-10 is Preparing to Fail: Part III of III

ICD-10 medical billing and coding

The Coming ICD-10 Cash Flow Crisis and How to Avoid It

The transition to ICD-10 will not be without its issues.

Mona Engle, RN, CEO/Practice Administrator of Drs. May Grant Associates, is concerned about coding outcomes. “If something is not coded correctly, the insurance company will not pay — so we have to do it right…The ICD-10 transition will [be] a difficult and costly endeavor,” she says.

By nine months from your deadline, your team should be documenting, coding and billing in both ICD-9 and ICD-10. For most of us, that timing falls around the end of 2013. Beginning the process of dual coding should consist of:

• Chart review by an ICD-10 trained medical coder to help you identify documentation needs for ICD-10.
• Increased training for the entire team.
• Implementing changes to processes and forms pertaining to your present coding and billing procedures.

At first, your coders may spend many hours “crosswalking” codes. That is, doing a side-by-side comparison of an ICD-9 code to its closest match in ICD-10. This is a challenge when the ICD-9 code for Extrinsic Asthma-unspecified (493.00) has 16 different code choices in ICD-10. Making the correct choice requires additional documentation detailing a number of factors.

“Crosswalking” requires referencing coding books, which is time consuming, so several software options are now available to make this process more efficient. Check out Simple Solutions, from Complete Practice Resources, or have your coders use ICD-10 Code Search, found online here.

Another key to success is communicating with all system vendors and business partners that use DRG codes to receive and send data to your systems. These may include pharmacies, labs, your EHR, etc. This is imperative to complete as you approach the deadline because a vendor’s plan for conversion to ICD-10 will directly affect your bottom line.

Some practices and hospitals are planning to test for internal ICD-10 compliance a full six months before the deadline, probably long before most of their external partners are ready to convert. If your vendors are not ahead of the game, you will need to develop conversion strategies or risk losing cash.

The ICD-10 transition is challenging, but it is not impossible…and it doesn’t end on October 1, 2014. Your ongoing job is to make sure that cash flow over the first three months of the new processes is affected as little as possible. Be ready to do immediate charting, coding and billing triage during the last half of 2014 and to immediately change the systems, habits and processes responsible for any problems. Ongoing issues cost very real money.

Reach out to industry organizations, professionals and your vendors to help make this transition a success. We are all trying to work as fast as we can to ensure that your practice come through this process with as little loss as possible. With your devoted time and attention, we can make that happen.