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Getting your physician practice ready for ICD-10

June 2015

By Reed Tinsley, CPA, CVA, CFP, CHBC

The ICD-10 transition date is October 1, 2015. The government, payers, and large providers alike have made a substantial investment in ICD-10. This cost will rise if the transition is delayed, and further ICD-10 delays will lead to an unnecessary rise in health care costs. So are you getting ready for the deadline for the new ICD-10? The ICD-10 transition takes planning, preparation, and time, so medical practices should continue working toward compliance.

The following quick checklist will assist you with preliminary planning steps. Identify your current systems and work processes that use ICD-9 codes. This is just the first step in the transition process. Examples of places that may need to be identified are clinical documentation, encounter forms/superbills, practice management system, electronic health record system, contracts, and public health and quality reporting protocols.

Talk with your practice management system vendor about accommodations for ICD-10 codes. With so many parts to a practice management system, it is imperative to speak with them about the transition. What are their plans to help you? When will this change be installed? Will it cost extra or is it included in the contract agreement? Discuss implementation plans with all your clearinghouses, billing services, and payers to ensure a smooth transition. Be proactive, do not wait. Make sure the organizations you conduct business with have a plan in place for their transition and dealings with ICD-10.

Talk with your payers about how ICD- 10 implementation might affect your contracts. Because ICD-10 codes are much more specific than ICD-9 codes, payers may modify terms of contracts, payment schedules, or reimbursement.

Identify potential changes to work flow and business processes. Consider changes to existing processes including clinical documentation, encounter forms, and quality and public health reporting.

Assess staff training needs. Identify the staff in your office who code, or have a need to know the new codes. There are various opportunities and materials available for training of staff. Coding professional s recommend that training take place a minimum of six months prior to the ICD-10 compliance deadline.

Budget for time and costs related to ICD- 10 implementation, including expenses for system changes, resource materials, and training. This is pretty self-explanatory. Asses the costs of the necessary software updates, reprinting of superbills, trainings, and related expenses. There is more than you realize.

Conduct test transactions using ICD-10 codes with your payers and clearinghouses. Testing is critical. You will need to test claims containing ICD-10 codes to make sure they are successfully transmitted and received by your payers and billing service or clearinghouse.

Keep up to date on ICD-10: Visit the CMS ICD-10 website for the latest news and resources to help you prepare: http://www. cms.gov/Medicare/Coding/ICD10/index.html.