How one physician practice is tackling transition to ICD-10


If haven't already started working on the transition to ICD-10, you might be in a heep of trouble down the road. Here is how one physician practice is tackling the transition:

Created a task force that meets weekly and communicates updates with the managers and clinicians (at least) monthly.  The practice's main areas of focus have included:

1.  Coding and documentation audit - it hired a consultant to review coding and documentation to discover what we need in those areas to be able to successfully bill (and get paid) in ICD-10.

2.  Training - the practice reviewed several training courses, went to ICD-10 training "bootcamps", got several of its coders ICD-10 certified, and is now putting together customized training for its clinicians and other end users.

3.  Practice management system and related upgrades - the practice upgraded to an ICD-10 compliant version of its medical billing software and is also changing EDI vendors to improve technical support.  The physician practice is also working with its vendors and third party payers to do as much testing prior to 10/1 as possible, and also to monitor transactions more closely after 10/1.

4.  Clinical content development - Its Health Information Management team is reviewing the results of the coding audit along with the materials from the software vendors to modify clinical content within the EMR and to also to facilitate correct coding.  Their plan is to begin testing this internally with the clinicians in the third quarter of this year after their training is done in second quarter.

5.  Communication and change management - this is a focus for every significant initiative in this physician group.

Here are some things to keep in mind with regard to ICD-10:

There is a lot of the training out there is simply not very helpful.  Some of it is a bunch of vague and semi-scary stuff about the history, the cost, and the whatever of ICD-10 generally. So you've got to do some due diligence before throwing time and money at training.

The payors seem not to be in a helpful mood. If you are having a positive experience, please let me know.  Many of the payors will not allow practices to test transactions with them prior to 10/1.  They are  saying something to the effect of "don't worry, we won't have any ICD-10 denials for X months during the transition", but I don't believe that this will be the case because any denial that is tangential related to a diagnosis will, by default, be "ICD-10 related".  So do all you can to vet with your payors beforehand, and again be extremely diligent with them after 10/1.

Finally if you a haven't done so, you might want to talk to your bank about increasing your credit line limit just in case cash flow goes to hell resulting from the potential havoc rendered by ICD-10.

Have questions? I’m here to help.