One month countdown to ICD-10: Are you ready?

August 18, 2015

Working with your vendors and partners can help guarantee success in the ICD-10 transition. Here's advice on how to make the last month until ICD-10 count.

FiabaneWorking with your vendors, payers, and partners can help guarantee success in the ICD-10 transition. Here's advice on how to make the last month until ICD-10 count.

Earlier this summer, the Workgroup for Electronic Data Interchange (WEDI), released results from its June 2015 ICD-10 Industry Readiness Survey and found half of physicians thought they would not be ready for the ICD-10 transition on Oct. 1, or were unsure.

Additionally, only about 20 percent of physician practices have started or completed external testing, and less than 50 percent responded that they were ready or would be ready for the transition deadline. Are you in this boat? As we near the deadline, do you and your practice staff know what you should focus on?

Related: ICD-10: Defeat the deadline

Here are some things to keep in mind in these crucial 30 days, as well as things to keep in mind post-deadline.

Need a new EHR for ICD-10? The ultimate checklist for your vendor

Working with your vendor(s)

Billing slip updates. If you are still using billing slips, ICD-10 is the perfect time to evaluate your charge capture options. With the increase in codes in ICD-10, it may be difficult to put all the codes you need on one billing slip. You should consider other options including capturing all diagnoses codes in an EHR, or using mobile charge capture options (for physicians that are not fully office based).

Testing interfaces. Are your vendors working together to ensure they have direct connections to exchange your data, aka proper interfaces? Additionally, have these interface connections been tested? If you're unsure whether your vendors have direct connections to exchange your data, it is important to ask if contingency plans are in place to ensure a smooth transition to ICD-10.

Add ICD-10 codes to future and standing orders. All future and standing orders scheduled to occur on or after Oct. 1 must be updated with ICD-10 codes. Future and standing orders that were not updated may require updates after Oct. 1, requiring more calls from labs to your office to get the new codes needed to fulfill the order. Proactively updating them now will save time later.

Practice selecting ICD-10 codes in claims and encounters. Have you practiced coding claims in ICD-10 yet? These should be actual claims and encounters. Your practice's ICD-10 lead should now be monitoring staff progress to learn if additional training or resources are needed for staff prior to the transition.

Review clinical accelerators in your EHR. Update your diagnosis workflows from ICD-9 to ICD-10 now to ensure providers are not significantly slowed down at the point of care.

Update reporting and documents. Determine if any clinical or financial reporting is diagnosis based. Any reports that use ICD-9 codes will need to be updated to use ICD-10 codes. Since there is not a 1:1 mapping of ICD-9 to ICD-10 codes, you may have to adjust your reporting to be compatible with additional codes and levels of specificity.

 

NEXT: Working with payers and more

 

Working with your payers

Have you been partnering with payers for testing and post transition planning?

If you have not already tested with payers, you should reach out immediately to see if they conducted testing on your behalf. Also, ask your payers about their plans following the ICD-10 transition. Make sure you are aware of their contingency plan and how your staff should reach them if there is a problem.

Related: Three medical billing strategies to counter ICD-10

Some other things you should keep in mind include:

  • Address gaps in payer readiness. If you send the correct code, are you certain of the response from the payer? Plan for your practice's reimbursement to be disrupted and think about how you will manage issues that arise. It's important to determine now which team members will be directly responsible for which tasks.

  • Leverage historical data. Remember, you have some current knowledge of payers' behavior and this can work to your benefit. What is your current claim denial rate and claim re-work burden? Plan for this to increase by allocating additional resources to handle outreach to the payers (e.g. payer phone calls, faxes, and portal work).

  • Plan for cash flow disruption. This should be part of your contingency plan. Cash flow disruption may occur due to payer issues; you should think about how long the disruption may last and implement a financial contingency plan for issues beyond your control.

Tapping into your network

ICD-10 is a fundamental shift in the way health care information is classified, since it allows for a lot more information to be reported. While this seems daunting and a task that would lower productivity, in the long run it will be beneficial to furthering the goal of delivering better outcomes at a lower cost.

The key thing to remember as you undertake ICD-10 is to hone in on the impact to your practice, as the increase in potential codes can vary greatly and you need to know where to focus your efforts. In addition, consider your vendor a partner who is there to guide you throughout the process. Reach out as often as necessary in this last month to make sure you are ready for Oct. 1 and to help you set in place your contingency plan post-transition.

Related:The ICD-10 transition: Avoiding revenue disruption

There are also third parties that can offer supplemental help such services to support professional change documentation at the point of care.

With one month until the big ICD-10 transition, take advantage of all resources at your disposal and make sure you are keeping the lines of communication open between staff in the practice, external vendors, and payers. ICD-10 can seem like the big bad wolf but as long as you prepare, you can rest assured you're sitting in a brick house.

 

Elysha Fiabane is senior manager for product innovation at athenahealth. She serves as athenahealth’s delivery lead for ICD-10, coordinating readiness and response activities across the organization. Fiabane can be reached at efiabane@athenahealth.com.