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6 must-do’s to increase your ICD-10 confidence



You’re likely concerned about the looming ICD-10 deadline, especially if you have a small, independent medical practice. You have lots to do already: you’re running a business, seeing patients, charting, surgeries, rounds, continuing education, trying to have a personal life, among many other things. On top of all of this, you’re secretly hoping ICD-10 will be delayed. Well, in case ICD-10 isn’t delayed, which it most likely won’t be, do you feel prepared? Are you not quite sure what to do to prepare or even start? Are you feeling the pressure that you and your staff aren’t trained and ready? Do you lack confidence? If so, you’re not alone.

I conduct many webinars and answer many questions from independent practices that deal with ICD-10. The general consensus is that most independent doctors and their staff are not prepared, but actually terrified of ICD-10. They are afraid of the unknown. After all, ICD-10 implementation is now less than three months away.

This list of six must-do’s will help you increase your level of confidence. Become more confident with ICD-10 and move forward. It’s really not that difficult. These six items will give you the tools and support to become more confident.

1. If you’re not sure how or where to start, I’m here to tell you that ICD-10 is not about the order of how to accomplish it, rather, finding the value in just doing it. It’s much easier to become familiar with ICD-10, and ultimately become ICD-10 compliant, with a trusted partner. Even though a partner will make it much easier, you need to work through the process each day. It needs to be you who understands your specific circumstances. Your work now will give you the much-needed confidence when that day arrives. Dig in and move forward a little at a time.

2. After digging in to understand your individual circumstances, you next need to understand how your top ICD-9 codes will map into the ICD-10 code set. This will help you to understand how the codes will impact your practice. Understanding the impact of the increased code sets will bring additional implementation needs to the surface. Here are some items you may find:

  • You may uncover the need of charge slip and workflow evaluations. If you use a paper charge slip, for example, when printed, the ICD-10 codes will most likely turn it into a large number of pages. What should you do going forward? Should you change to an online charge slip or are there other ways to continue with paper charge slip?
  • It will help uncover needs for chart auditing. If your top 5 codes explode into lots of ICD-10 codes, you will need to make sure documentation is being captured to get to that level of specificity.
  • Lastly, it may identify the impact of your coding process and charge posting process. Who is doing coding now and do they need training? Do you have the resources to accommodate productivity? Do I have a holistic view of the charge process?

3. The new ICD-10 codes will require chart auditing prior to the implementation date. Some practices will also most likely need to consider getting additional outside coding assistance. It could uncover impacts such as workflow, training, affect productivity, address the needs to change current processes to capture the detail in the clinical note and it may necessitate a change to the level of detail available in patient charts. Walk through the process of auditing a chart and the impact will become much more clear.

Assessing the template in your EHR to ensure the right items are there to capture the needed clinical information. Walk through the process of chart auditing and the process of helping the physician capture important pieces of information. This also helps uncover where the coding staff needs more training.

4. Next, testing claims now is critical to give you the confidence that your current vendor, clearinghouse and carriers are compliant. Unfortunately, testing opportunities are difficult to find right now. It’s important to look at your top carriers that are 70-80% of your revenue, then to reach out to those carriers and ask them for testing opportunities. Reach out to your vendors quickly, to see if they can offer assistance with testing opportunities. This will really help you understand what ICD-10 will look like for your practice. You will get a much better understanding. At this point, it is all about practice workflow and testing, so test, test, test.

5. You need to know and understand your key performance indicators (KPIs) to compare items such as your charge lag report when ICD-10 takes place. If your practice currently has an average two-day response time, you can easily see how these changes will be affected in October. Recognizing an increase in days early on will reveal where you need to make quick adjustments to prevent any concerns with cash flow. Practices should identify the most commonly used ICD-9 codes as well as the most common types of procedure or groups of codes. Then set KPIs around these metrics.

6. If you’ve already completed the previous five steps, there is one additional area for you to focus. Put extra time and effort into collecting all you can now. It’s important for you to bring the days in accounts receivable (A/R) down now, especially from your top carriers. If not, the days in A/R will soon get out of the control due to your carriers. You need to have a cushion for that now to help prevent cash flow problems later on. Find holes in their workflow to collect both insurance and patient money, especially the carriers with a higher revenue impact.

Even if you’re not quite sure what to do to prepare, or even start, with ICD-10, now is the time to get started. Gaining your confidence now with ICD-10 is not about the order of how you do it, but the value in doing it. Find the value in trying to work the process every day and you will have more confidence when the day gets closer.

Access recorded webinars specific to preparing for ICD-10.

Register for an upcoming ICD-10 webinar on July 22: ICD-10 Get started and keep moving.

Topic: EMR/EHR, Medical Billing

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