The Smart Medical Practice

It’s Time to Get Serious About ICD-10

The transition from ICD-9 to ICD-10 is a major one, and many practices continue to put off preparation. Some believe CMS will extend the October 2014 deadline, while others are occupied with other issues.

At this point, it seems certain the deadline will not be extended, and there may be serious issues stemming from a lack of preparation:

  • prepare for icd 10 codesBecause of the extension already given, CMS says there will be no grace period—claims using ICD-9 codes after 10/1/14 will be denied.
  • Practices that are counting on their billing software to translate the ICD-9 codes into ICD-10 codes are making a false assumption. There are about 13,600 ICD-9 codes and 144,000 ICD-10 codes, so simple crossovers are not possible in most cases.

CMS has been urging practices to take this transition seriously for some time. It provides implementation guides for small and medium practices on its site, along with checklists and timelines. Notably, the timeline shows formal, comprehensive documentation and coding training beginning in January.

There are some steps your practice needs to take before formal training begins, so here’s a plan for the next few months:

  1. Conduct an assessment to determine your readiness state and identify the 50 or so diagnoses codes used most frequently in your practice.
  2. Determine whether anyone on your staff needs training in anatomy (ICD-10 documentation is highly detailed and requires some anatomical knowledge). 
  3. Create a plan that includes who is responsible for making sure the training occurs in a timely fashion, who will teach the training, who will receive the training and when they will receive it. Clinicians and physicians should receive at least 16 hours of training on the new codes, according toCMS.
  4. Begin informing physicians, clinicians and staff about the upcoming training and its importance. Because ICD-10 codes incorporate so much more information than ICD-9 (location on the body, new or subsequent visit, etc.), the information taken during intake or triage will be critical to proper final documentation. Show physicians the detail involved in ICD-10 coding to help them understand why their documentation practices will have to change. A 50-chart audit is an excellent way to illustrate the necessary changes.

Once those steps are complete, your organization should be ready for formal training. Many experts recommend sending your key staffers to outside ICD-10 training or having a trainer come to your office.That training period is the perfect time to start the next phase of preparation: making sure that all your revenue-related vendors are ready for the new codes. Don’t just quickly verify their readiness—ask them to tell you their plans in detail.

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