ICD-10 Delay is an Opportunity to Prepare Your Practice

Pen stethoscope and paperWith the mandate to implement ICD-10 delayed until October 1, 2015, practices have an unexpected opportunity to prepare for a seamless adjustment when the change takes place.

CMS officials have repeatedly warned physicians to anticipate productivity hits and revenue losses in the initial three to six months post implementation due to the steep learning curve associated with the use of ICD-10. Evidence shows that virtually every other country that has implemented ICD-10 experienced some level of productivity impact. Canada, which has a government-run (single-payer) health care system and used a more specific code set when implementing ICD-10 back in 2001, took a 50 percent slash in productivity that lasted approximately six months.

Minimizing the negative impact of ICD-10 implementation on your practice is important, and taking the time to prepare now will be well spent in terms of preparation and planning. There are many things that you can do today to prepare your practice for ICD-10 in order to mitigate some of the potential negative business impacts.

Look at Your Documentation

Clinical documentation improvement is, by far, the best thing that a physician can do to advocate for their business. Start becoming a better documenter by running productivity reports (around diagnosis codes) and look for your top 25 most frequently used diagnosis codes. Start to translate some of your data from ICD-9 to ICD-10 and look up the code descriptions and compare them to how you document today. Documenting your charts today with an added level of specificity to fit the requirements for ICD-10 will help your transition.

Set Aside Time to Meet with Your Coders and Billers

Since ICD-10 requires a greater level of specificity, plan for extra time to meet with your billers and/or coders because inquiries will be coming in more frequently. If you don’t already have time set aside to meet or discuss questions with your coders, start scheduling more time to go over their questions. Consider setting aside 20–30 minutes every week when they can come to you with questions, rather than trying to track you down between patient visits to get their questions answered.

Expect an Impact to Prior Authorizations and Claims

Expect delays in prior authorizations and an increase in claim rejections, especially if mistakes are made. Typos, errors, and other transaction issues will inevitably happen and can cause an increase in claim rejections, which will add up to productivity and revenue impact. More administrative time will likely need to be spent to address these issues.

Train Your Staff

Preparing and training appropriate staff for the coming changes should be an important part of your ICD-10 implementation plan. If your administrative staff handles prior authorizations, referrals, coverage, and eligibility issues, they will also need to know about ICD-10 coding changes. Revenue cycle staff will have to stay on top of payer policy and contract changes, as these will most likely change as well. Management staff will require training as well, so they can be aware of what components of your practice need preparation and monitoring leading up to implementation and beyond.

Need more resources to get your practice ready for ICD-10? Visit www.massmed.org/icd10 or contact the Physician Practice Resource Center at pprc@mms.org.

—Talia Goldsmith
PPRC advisor

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