Medical Billing Blog

MBR Take-Aways 

1. It’s especially important that all administrative and clinical staff receive ICD-10 training. Some staff, like physicians and coders, will require more in-depth training of the new code set.
2. There are many different training options – classroom style, online courses, webinar, self-taught. Finding the correct mix of training options is important to increase overall understanding, while keeping the overall costs manageable.
3. Don’t forget to calculate biller/coder/physician down time while they are in training.

This time next year, new coding changes from ICD-10 will be in its first couple weeks of implementation. While this substantial revision to the international classification of diseases is certain to create uncertainty among billers, physicians, and payers, it will also create an opportunity to develop new competencies and skills. Preparation is key to maximize your results, and it starts with your medical staff. CMS recommended steps for small to medium practices to follow to make the transition and training process go more smoothly. Developing a plan for the changeover to ICD-10 coding must be done only after a comprehensive assessment of your staff’s needs.

The healthcare industry is changing rapidly and providers are facing many new challenges, with ICD-10, meaningful use, and fee schedule reductions being only a few. If you feel like there are just too many cats in the herd, there is one area where you can take control of the situation, and that is by re-evaluating the effectiveness and adaptability of your billing function.  Whether you have an in-house billing staff, or an outsourced revenue cycle management team, it’s crucial to make an accurate assessment of the processes associated with your billing function to ensure that you are not part of the majority of practices expected to face serious cash flow problems when ICD-10 goes into effect next October. 

When the transition to ICD-10 officially begins on October 1, 2014, those in the US healthcare industry will be in a position to benefit greatly from lessons learned by our neighbors inCanada, who also recently made the transition between 2001 and 2004.  Canadians already experienced similar transition situations to what the United States will be facing according to Cindy Grant, Certified Healthcare Information Manager (CHIM) and ICD-10 practice lead at TELUS Health Solutions in Toronto,Ontario; and Kerry Johnson, MAEd, CHIM, senior lecturer and HIM instructional coordinator at the University of Ontario, Institute of Technology in Oshawa,Ontario.  Coders in Canada struggled most with anatomy and physiology, not the coding logic itself.  "It wasn't so much the coding system and how the codes work," says Johnson.  "We found them struggling with anatomy and physiology and understanding what exactly the intervention was, including determining the root operation."

A recent survey conducted by the Workgroup for Electronic Data Interchange (WEDI) regarding the preparations for transitioning to ICD-10 being conducted by healthcare providers shows that nearly half of the survey group either have not started preparing for ICD-10 or do not know when they expect to start their testing. 

Providers should start preparing now for the implementation of ICD-10, which is scheduled to begin October 1, 2014.  Basically let’s talk about getting your practice's infrastructure in order. 

The federal government has finalized a one-year delay for the nationwide conversion to ICD-10 code sets beginning Oct. 1, 2014.  HHS Secretary Kathleen Sebelius has announced a final rule establishing a one-year delay - from Oct. 1, 2013, to Oct. 1, 2014 in the use of the ICD-10 Coding system.   

Although the final ICD-10 implementation date has not been set, it’s important to continue planning for the transition.  The switch to ICD-10 will affect every aspect of how your organization provides care, from software/hardware upgrades to documentation, and even reimbursement issues.  Take time to assess everything from coding and documentation to interfaces, training and financial implications.  Some areas that require special attention include:

Since HHS has proposed a year-long delay of implementing ICD-10, questions have been asked regarding the current ICD-9 code freeze. CMS confirmed that the code freeze will hold until ICD-10 is implemented, regardless of the delay, according to Pat Brooks, RHIA, and senior technical advisor at CMS.

In a new press release from HHS, Secretary Kathleen Sebelius announced a proposed rule that would delay the compliance date for ICD-10 from October 1, 2013 to October 1, 2014.

Health and Human Services Secretary Kathleen G. Sebelius today announced plans to postpone implementation of International Classification of Diseases, 10th Edition Diagnosis and Procedure Codes (ICD-10) by certain health care entities.