Is Your Practice Ready for ICD-10?

The International Statistical Classification of Diseases and Related Health Problems, often referred to as ICD, is approaching the mandate of its 10th iteration of codes. This means that in order to not only remain in compliance, but also to deliver top patient care, medical practices across the country need to ensure that their staffs are prepared through training and and other resources. ICD-10 includes more than 14,000 medical conditions, and in some cases, it can include over 16,000 conditions when...

What’s Really Going On With ICD-10?

Overall, the news from a recent AHIMA survey on ICD-10 preparation isn’t bad. However, it’s clear that some physicians simply will not be ready next fall, despite having had an additional year to prepare for the changeover. The American Health Information Management Association (AHIMA) surveyed 454 healthcare organizations in May and June of this year. Seventy-three percent of respondents were healthcare delivery organizations, with acute care hospitals making up 30% of those surveyed and clinics/physician practices making up 25%. In...

ICD-10 Delay Leaves Health Care Professionals Frustrated

Many health care professionals breathed a sigh of relief in late March when the U.S. Congress delayed implementation of the new ICD-10 coding set along with a Medicare Bill. However, other doctors and health care administrators were frustrated by the delay. Some find it disheartening after being assured repeatedly that this change-over would take place as originally scheduled. Such frustrations are understandable. The administrator of the Center for Medicaid and Medicare Services (CMS), Marilyn Tavenner had warned the medical community...

Data, Financial & Productivity Losses to Accompany ICD-10 Conversion

Thanks to the HHS mandate, in six months the healthcare system will be facing the transition to ICD-10. This transition may spell trouble for some healthcare infrastructure providers and large facilities as experts are anticipating data and financial losses. In fact, researchers from the University of Illinois at Chicago have indicated the transition may not only cost healthcare facilities significantly more money than previously thought, but have other unwelcomed side effects as well. Although no cute or funny code exist...

Must-Ask ICD-10 Questions for Your Medical Billing Vendors

Although the deadline for ICD-10 has been pushed to 2015, and everyone who was ill-prepared can now take a deep breath, the time to train, test, and monitor the progress of knowledge and coding efficiency is now. Physician were by far the largest group to report lagging behind in preparedness. Likewise the small samples of dual coding from billing departments revealed similar weaknesses. In a previous post on how other nations fared making the transition, it was shown that it...

Cost of Implementing ICD-10 Higher than Expected

Implementing ICD-10 by the October deadline may be more costly than initially expected. In the updated report entitled “The Cost of Implementing ICD-10 for Physician Practices,” Nachmison Advisors estimated costs dramatically higher than initial estimates from 2008. Large healthcare provider: $2 million to $8 million: 2014 revised estimate $2.3 million: 2008 initial estimate Midsized healthcare provider: $213,364 and $824,735: 2014 revised estimate $285,195: 2008 initial estimate Small healthcare provider: $56,639 to $226,105: 2014 revised estimate $83,290: 2008 initial estimate The...

90% of Physician Practices Not Ready for ICD-10

With the October 2014 deadline for physicians to transition from ICD-9 to ICD-10 approaching, less than 10% of private practices are ready. In a survey of medical professionals, Porter Research found that even though 87% of respondents said they are confident they will be ready when the time comes, 74% had not started the implementation process in the final quarter of 2013. Kind of makes you shake in your boots, no? A significant majority of respondents expressed concerns about loss of revenue...

The Sin of Not Paying Attention To ICD-10

Not complying with the new ICD-10 updates may not land you in a version of Hades, but when your claims start bouncing back, that’s how it will feel. Don’t ruin the cash flow of your business by ignoring an essential part of good healthcare administration. Get your ICD-10 coding book now and get to work updating your practice before the newly revised October 1, 2015 start date. Here are a few key items to consider: Buying the Book The ICD-10...

3 Simple Tips for Making Your ICD-10 Conversion Less Painful

The deadline for converting from legacy ICD-9 coding to the updated ICD-10 system is October 1, 2014. According to a study published in December 2013 by the Workgroup for Electronic Data Interchange, around 80 percent of providers have yet to begin testing. Some offices are waiting for software updates; others haven’t even begun the conversion process. There are some things providers can do to get ahead of the challenge and ensure ICD-10 compliance by October. Ask for Demos and Assistance Request...

5 Amazingly Easy Ways To Avoid ICD-10 Fraud Issues

Earlier this month, we talked about the potential for longer claims cycles as automated detection systems are temporarily derailed by the ICD-10 changeover. In our last post, we discussed mitigating the risk of being falsely accused of fraud by moving to ICD-10 as soon as possible and hiring an independent auditor. Today, we’ll go into more depth on the steps practices can take to avoid a Medicare audit and how sophisticated coding software can guide you to the right levels...

Medical Billing Coding Goes Mainstream

Is there a perfect storm coming in the form of ICD-10 coding, ACA reforms, and Meaningful Use? Will some doctors go out of business because of a failure to prepare for the ICD-10 changeover? All of these possibilities were explored in a New York Timesarticle last week. The article starts out playfully, noting that ICD-10 includes medical billing codes for a person who drowned from jumping off burning water skis, someone who was injured in a spacecraft, and someone who...

Will ICD-10 Fraud Trigger Longer Revenue Cycles?

Much has been made about the challenges associated with the ICD-10 transition in October, including expected problems with medical billing coder productivity. But little has been said about another challenge likely to affect the industry: fraud detection. There are several types of fraud prevention measures currently in place, and some are not affected by the coding system (e.g., anonymous reporting outlets for Medicare fraud). But fraud detection algorithms used by payers are based on machine “learning” related to the code...