The Smart Medical Practice

New ICD-10 Software Guide: Interview with Gaby Loria of Software Advice


Medical RecordsAs we countdown to October 1, for many, readiness for ICD-10 will come down to the wire. Here’s the latest:

Good news came July 6th when CMS announced a coding leniency contingency, stating that ICD-10 claims with errors will not be rejected if they bear codes from the proper family. The downside to this contingency is that it applies only to CMS, meaning that commercial payers will do what they will come Oct 1st. (see petition to President Obama)

Surprising news (not good surprising) came from MGMA as their most recent survey found that 25% of respondents were still using ANSI 4010 version billing software. This is possible because clearinghouses are able to convert claims to the 5010 standard. (We recall the entire industry moving to version 5010 back in Jan 2012.)

But the hardest news came from WEDI’s most recent report, which was positive for just about everyone––except physicians. “Nearly one-quarter of physician practice respondents said they will not be ready by the October 1 deadline, and another one-quarter were unsure,” said Jim Daley, WEDI past-chair and ICD-10 Workgroup co-chair.

But there’s some good news for medical practices that now find themselves behind the curve on The Road To 10. A new ICD-10 Software Guide from Software Advice shows how advanced software can practically help physicians and their office staff make the transition to ICD-10 by using what they already know about ICD-9. In an expert interview with Software Advice Market Researcher Gaby Loria, we found a glimmer of silver lining for those struggling to step up: We asked her the following questions.

What was the impetus for creating this guide?
“There’s a lot of anxiety, particularly among smaller practices, about how to best handle the ICD-10 transition without spending too much time or money preparing for it. That’s why we set out to provide a resource that could help physicians not only plan their transition strategy, but also learn about some of the leading ICD-10 software solutions available right now”.

Why did you choose to feature PracticeSuite?
“We considered a large number of software vendors for this piece, and PracticeSuite stood out for many reasons. At a time when some of its competitors are struggling to develop ICD-10 ready capabilities, PracticeSuite is already offering a robust set of functionalities in a sharp, easy-to-understand layout. We were particularly impressed by the fact that practices can employ multiple methods of looking up the right codes for every patient encounter by using General Equivalency Mappings (GEMs), the ICD-10 Alphabetical Index and the Tabular List”.

What’s the most important takeaway for providers?
“Our guide is intended to help physician users realize the many hidden capabilities of medical software. Often, providers are hesitant to consider a software purchase because it’s difficult for them to see the return on investment or how much “bang” they’ll get for this buck. With this resource guide, we want to detail the various ways software can automate every part of an ICD-10 transition, so providers can save time and prevent claims issues from interfering with their reimbursements”.

Our take away from the interview with Gaby is that come Oct 1, getting paid on medical claims will come down to: 1. Front office staff having the right ICD-10 tools to determine benefits and patient pay and to obtain authorizations; 2. Billing staff having enough ICD-10 data from physicians to obtain the right family of codes; and 3. Physicians having easy to use lookups and cross-walks that allow them to select a familiar ICD-9 code and then see the corresponding choices of relevant ICD10 codes side by side.

Try PracticeSuite’s ICD-10 Code Lookup.


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