It’s time to prepare for the ICD-10 conversion that’s takes effect on Oct. 1, 2014. It’s important for physician practices to understand that even though there's more than a year left to prepare, it’s going to take a lot of time and effort to get ready.
5 Things You Should Know Now About ICD-10 Conversion
1. You need a strategic plan.
Take the time to assess your current internal workings and find out what your top-paying codes are. These won’t necessarily be the ones that reimburse the most, but rather the ones you use most often and make up the majority of your business.
If you aren’t able to code for heart failure when 95 of your patients have heart failure, for instance, you’re not going to get paid. Identifying your potential liabilities this way will help you put a plan into place.
2. Work with your partners.
If your EMR vendor hasn’t told you about the plans they have in place to handle the conversion and can describe how coding is going to get done, you need to ask about it. And if they don’t have a plan, you’ll need to prepare your company.
Work with your vendors to find out as soon as possible what tools they will use to input ICD-10 codes. They should have at least some ideas about putting a process in place to approach the conversion in a timely and relatively smooth manner.
3. Educate yourself.
Knowing what ICD-10 is and what it means for you will go a long way in preparing you for the conversion. There are more codes that allow you to be much more specific when it comes to recording diagnoses. For example, for surgeons, there are codes that make it possible to record the goal of the surgery -- whether is is palliative or curative.
Because these new codes will be much more complex, you will also need to ensure that your clinical documentation can back them up. It's not sufficient to say “heart failure,” for example. ICD-10 requires that it be classified as acute, chronic, acute on chronic, and so o. No matter how you classify it, you will need to make sure your clinical documentation is sufficient to support the more complex codes.
4. Wean yourself from 4010 format.
Some practices are still submitting claims in 4010 format and the clearinghouse converts it to 5010. The thing is, there will be no such thing as a 4010 ICD-10 once the switch is made. Find out whether your practice is submitting 4010s or has switched to 5010s.
5. Prepare for the worst...
...and hope for the best. Smaller practices often find these kinds of conversation disruptive, so take steps to protect your practice through the transition. Don’t take on giant capital expenditures leading up to the conversion because you may have substantial cash-flow issues when it comes -- especially if you haven’t prepared properly.
It’s unlikely that the conversion, because of its size and scope, will go off without a hitch. CMS and payers have said as much, so be prepared for cash flow issues. The time to start preparing, if you haven’t already, is now.
Logan Solutions uses a combination of clinical practice expertise and technological skill to help physician practices throughout the U.S. implement, customize and improve their ERM and Dragon Medical software systems. Contact us to find out how our clinical-practice expertise can help your practice with its clinical documentation software needs.