ICD-10 is coming and making sure your practice is ready for the transition is easier said than done. There are many resources out there including the American Medical Association (AMA) who have provided expert advice about preparing for ICD-10. If you haven't had the chance to do a lot of research yet, don't worry...the clock is ticking, but it's not too late.
Tips to get you on the road to ICD-10 readiness:
- Identify and plan for updating all of your systems to ICD-10 by making sure you have a clear understanding of which of your current systems and processes currently use ICD-9 codes.
- Communicate with your payers and clearinghouses to determine their system readiness and ask questions about what they're doing to prepare.
- Ask your payers if there are any contractual changes regarding coding specificity that could affect how you process claims.
- Carefully document any potential workflow changes that may be required due to ICD-10 implementation. Areas to consider include:
- Clinical documentation
- Superbills or encounter forms
- Quality and public health reporting
- Determine the training needs of your staff and plan accordingly. Based on their roles, your staff will require different specific pieces of education around ICD-10 coding. Do your part to make sure that they are prepared well in advance for these new codes.
- Plan for added expenditures in time and resources as you work to prepare your practice and your staff for this change-over.
- Test, Test, Test - When the time comes (well in advance of the October 1, 2014 deadline) be sure to test your transaction submissions with your vendors, including Meditab, payers and clearinghouses, to be sure things are working and your claims are going through properly.
Why the ICD-10 codes are changing
- ICD-9 is not specific enough for detailed diagnoses.
- The current codes don’t reflect new services and technology in CMS payment systems.
- ICD-9 is limited to a maximum of 13,000 codes. ICD-10 will have more than 70,000.
- Finding the correct code is difficult under the current system.
- Existing codes don’t allow comparison of costs and outcomes.
- ICD-10 will include more precise documentation of clinical care.
- New data will help determine public health needs and identify trends.
- ICD-10 codes will help spot bioterrorism and epidemics.
ICD-10 Boot Camp: Basic Training 101
Is your practice ready to hit the ground running with ICD-10? Whether you’re just getting started or well on your way, these FAQs will help your team gear up for the transition:
Is training really necessary?
Definitely. In order to maintain their certifications, all medical coders must take a minimum number of ICD-10-specific CEUs before the compliance date. Each certifying organization determines the number of CEUs required. For specific requirements, contact your certifying organization.
How much training does my staff need?
Begin by conducting a gap analysis to determine your team’s knowledge of medical terminology, pharmacology, pathophysiology, anatomy and physiology. Review samples from different types of medical records to see whether the current level of documentation contains enough detail for ICD-10 coding. These will help you determine a baseline for your training needs.
Where can I find training tools online?
CMS provides valuable tips and tools on its website and you can sign up for email updates and tweets on the latest ICD-10 news. CMS and Medscape Education also have collaborated on two video lectures and an expert article providing practical guidance. Access to these resources is free for anyone who registers with Medscape. Physicians who take a post-test after completing the activity will receive CME credit. They include: ICD-10: A Guide for Small and Medium Practices, ICD-10: A Guide for Large Practices and Transition to ICD-10: Getting Started.
IMS Product FAQs
In IMS, what are some of the frequently used screens that will have ICD-10 codes added?a) Setup → Bill → Diagnosis code
b) Setup → Bill → Diagnosis template
c) Visit Note → Diagnosis
e) Charge posting
How will ICD-9 codes be phased out?Starting Oct. 1, 2014, ICD-9 codes will be enabled only for those visits prior to Oct. 1, 2014. All IMS reports will display ICD-10 codes for those records that have a service date after Oct. 1, 2014.
Can IMS accommodate both the DSM-5 and DSM-4 code sets, as well as the ICD-10-CM/PCS and ICD-9CM code sets, in a dual-use testing strategy? Yes. DSM codes are treated as ICD codes in IMS.
How will the DSM-5 compatible application version handle DSM-4 codes interfaced with other applications?While the application is made DSM-5 compatible, it also will be built to handle DSM-4 codes that are compatible with third-party systems like labs, registries and clearinghouses.
How will the ICD-10-CM/PCS compatible application version handle ICD-9-CM codes interfaced with other applications?While the application is made ICD-10 compatible, it also will be built to handle ICD-9 codes that are compatible with third-party systems like labs, registries and clearinghouses.
How do you intend to support testing of interfaces?IMS is integrated with HL7, lab, immunization and data conversion interfaces. We have an internal testing process to have two rounds of testing with all the interfaces. Before roll-out, we will make sure that our application is compatible with all the interfaces.
How will my facility test and implement the DSM-5, ICD-10-CM and ICD-10-PCS code sets in this application?Meditab has an in-house implementation team who can work with your facility on-premise or remotely, and our experts will perform all the initial testing and training.
Is additional hardware needed for the upgrade and testing?No additional hardware is required for ICD-10 implementation.
What customer support and training can be provided for the new version of the application?Meditab will host a webinar for all of its clients and will be posting the recorded session online for clients to access.
What is the contingency plan if the application is not ready for go-live on October 1, 2014? How long will it take to implement the ICD-10-CM/PCS-compatible version?By all means, our application will be ready for go-live before October 1, 2014. In worst case, the contingency plan would be to work with all of our clearinghouses, registries and labs and make sure that the business is not impacted. Also, we will put in all our efforts to roll out the application within a few days of the deadline, in case.
Key facts about ICD-10 documentation
Most ICD-10 training focuses on the coding and billing staff, but physicians have a learning curve too. They will be required to provide more detailed documentation in visit notes to correlate with the new codes. Physicians with specialty-specific tools will be in the best position to make sure ICD-10 doesn’t have a negative impact on their revenue stream.
Physicians and coders will have many more options with ICD-10.
- ICD-10 codes have seven alpha-numeric characters to add more specificity.
- The current ICD-9 coding system has only three or four numbers.
- Only 24% of ICD-9 codes will have exact matches in the ICD-10 code set.
- More specific information must be provided about some variables.
- Payers will reject claims that do not have specific, accurate coding.
Many professional organizations provide physician education on ICD-10 documentation. The American Health Information Management Association, for example, recently launched a series of brief three- to five-minute online training modules designed to fit a physician’s busy schedule. The self-paced training can be accessed from mobile devices, is specialty-specific and covers the most diagnosed and billed conditions. The Healthcare Information and Management Systems Society (HIMSS) also offers tips and tools for physician education.
Electronic Health Record systems like IMS from Meditab Software provide you with the built-in templates and tools you need for ICD-10 compliant documentation. Whether you're a current customer or are considering IMS for your practice, we invite you to contact us with any questions you may have regarding ICD-10.
Top 3 Ways to Engage Physicians in ICD-10 Training
Wondering how to engage physicians and ensure buy-in about ICD-10? The American Academy of Professional Coders (AAPC) recently conducted an industry survey to discover just that. The three most effective strategies cited were:
- one-on-one conversations
- educational presentations during medical staff meetings and
- directives from hospital administration
Brian D. Murphy, CPC, AAPC’s Director of the Association of Clinical Documentation Improvement Specialists (ACDIS), shared the survey results during a recent podcast on the importance of clinical documentation improvement (CDI) as it relates to ICD-10.
About 400 people responded to the survey, and of those, 50 percent said they have begun formal training in preparation for ICD-10. Nearly half – 46 percent – said they plan to train their physicians in ICD-10 documentation by the end of the year.
Physician education is a key part of ICD-10 implementation because clinical documentation improvement (CDI) is essential for its success. CDI is becoming more widely recognized as a critical topic for medical facilities across the nation, particularly as the October 1, 2014 deadline for ICD-10 edges closer.
You can read the entire survey results, or learn more about AAPC’s ICD-10 documentation training and assessments on the AAPC website.
Additional resources: ICD-10 webinars and provider calls
Read dozens of articles about ICD-10 and still have questions? Maybe you prefer webinars or provider calls. If so, check out some of the many online resources to help you prepare for the October 1, 2014 transition to the new diagnosis codes.
View a Meditab-sponsored webinar "Preparing for the ICD-10 Transition" presented by Betty Hovey, CPC , CPC-H, CPB, CPMA, CPC-I, CPCD, of AAPC. This archived webinar discusses the transition to ICD-10 codes, including clinical documentation assessment and training, for your medical practice.
- Archived version of Webinar
- Webinar Slides
- White Paper: Is Your Practice Ready For ICD-10? What You Should Know Now to Prepare Additionally, CMS has posted a one-hour YouTube webinar on transitioning to ICD-10. Hosted by the CMS Regional Offices, it covers the background and impact of ICD-10 on the healthcare industry and CMS ICD-10 implementation. Targeted by time zone, the webinar focuses on how CMS is working with individual states and partnering with the industry, and it features best practices, frequently asked questions, resources and contact information.
The CMS channel also features a national provider call where subject matter experts review basic information and answer questions about the transition to ICD-10 and implementation planning and preparation strategies. They cover code updates, Medicare claims processing, billing and reporting guidelines, as well as an update on national coverage determinations.