Practice owners must talk with their vendors now about ICD-10 updates

Renee StantzQ: We are worried that our vendor won’t be ready for the ICD-10 updates by October 1, 2014. What are some of the questions we can ask and how do we ensure that our vendor is ready?

A: This is a great question because most vendors will need to update their systems to be able to support the International Classification of Diseases, 10th edition, Clinical Modification (ICD-10-CM). 

You’ll first need to assess how the ICD-10-CM conversion will impact your practice.  This means that you should list all your computer systems that currently include diagnosis coding, starting with your practice management system and electronic health record (EHR).  Other systems that could be impacted include a disease management registry, e-prescribing module, and code selection software.

Once you’ve assessed your practice’s software systems that need to be updated for ICD-10-CM, you can then contact your vendor(s) for each of these systems.  The American Medical Association (AMA) suggests asking your vendor the following questions:

Will you be doing updates to my system?

Some systems may be too old and the vendor may no longer support them.

When will you be installing the updates to my system?  

Vendors have many customers, and it may take time before the vendor can complete the work on your system.

Will there be a charge for the updates to my system?

Check your contract, but also confirm costs with the vendor.  Some regulatory updates are done at no charge, but the vendor may also have to make improvements to your system in order to be able to install the updates.

How long will my system be down during the installation of the updates?

You will need to be prepared for how you will complete ongoing tasks while the system is down.

Will my practice management system support entering the ICD-10 codes and then transmitting the code to my billing vendor, clearinghouse, and/or payer?  

You will want to confirm that your system will support entry of the ICD-10 codes and transmission of the codes.

If your system will not support this, you will need to work with the organization(s) you are transmitting the data to and determine how you will send the ICD-10 codes to them.  Your billing vendor or clearinghouse will be unable to convert an ICD-9 code to an ICD-10 code for you.  You will have to be able to send the ICD-10 code for the claim and other transactions.

Will you complete any testing of my system after you complete the updates?  

Practices will want to complete “internal” testing of their systems to make sure they can enter and generate ICD-10 codes when appropriate. Your vendor may do this when they install the updates, but you will need to confirm this with them.

What services or products are you providing to support ICD-10? 

Ask your vendor what additional services or products they have available to support ICD-10 coding. While the services or products may add additional costs to your system, they may support easier and more efficient coding.

Meaningful Use impacts

For physicians participating in the Meaningful Use of Electronic Health Record (EHR) Program for Medicare or Medicaid, be aware that any claims submissions problems that occur after October 1, 2014 as a result of moving to ICD-10 could disrupt your reporting requirements for the EHR program. 

Work with your vendor to ensure the EHR updates are completed, along with the ICD-10 updates, prior to October 1, 2014 and consider completing your EHR reporting prior to the switch to ICD-10.

More questions to ask your vendor

The Centers for Medicare and Medicaid Services (CMS) advise physicians to ask the following questions:

• Will a mapping or crosswalk strategy be used between ICD-9 and ICD-10 code sets?

• What is your timeline for system modifications and what do those modifications include?

• Will you continue to support applications or are you discontinuing some products in the wake of the ICD-10 transition?

• Are there any new hardware requirements associated with ICD-10-related software changes?

• Will training be provided for any new ICD-10-related functionality, and is there a charge?

• Is there a phased approach for implementing ICD-10?

Questions to ask a new vendor

• For new vendors, the following questions are suggested:

• How does your product simplify my organization’s transition to ICD-10?

• How does the functionality offered by your system compare with my current system?

• Does your implementation require a complete system conversion?

• Based on what I already have in place, how much will it cost to convert to your system?

• What are the costs of maintenance for your product?

• Who in this area is using your current system? Talking to vendors’ existing clientele in your area about their experience with that vendor may help you identify if the vendor’s services are a good fit for your organization.

• What kind of product quality guarantees do you offer, and are these guarantees included in the contract?

• What is your timeframe for implementation?

It can’t be stressed enough: Practice owners need to work with their vendors now to make sure that your system updates are done in plenty of time for you to be prepared for the October 1, 2014 deadline. 

The answer to our reader’s question was provided by Renee Stantz, a billing and coding consultant with VEI Consulting Services in Indianapolis, Indiana. Send your practice management questions to medec@advanstar.com.