In just over a year, the latest version of the International Classification of Diseases (ICD) system will be implemented, significantly altering the coding process for medical billing operations. While the time and energy needed to master the ICD-10 system – which is more complex than the ICD-9 system – may seem cumbersome, the Centers for Medicare and Medicaid Services explain healthcare providers will enjoy higher revenue, less paperwork and increased clinical efficiency with the upgrade.
To ensure these benefits manifest, however, medical groups should must not take the changeover lightly and start working out the kinks early to avoid common pitfalls and costly errors during initial phases.
There are a variety of training and educational resources available to medical groups that outline what requirements must be met and the changes that were made to the Procedure Coding System (ICD-10-PCS) and Clinical Modification (ICD-10-CM) functions. Many anesthesiology, radiology and pathology practices chose to work with medical coding and billing experts to learn from industry experts and gain hands-on experience with the latest technologies.
Why All The Fuss?
Transitioning to the ICD-10 system includes more than just learning some additional codes. Many codes have been changed between versions 9 and 10, and specialists must understand the differences and know the appropriate use for each to ensure strong revenue flows and limit denials. As the coding switchover directly impacts financial stability, the sooner clinicians gain exposure and familiarity with the new code set the better.
Rather than throwing a medical group into the ICD-10 system on their own, medical coding and billing experts offer guidance and best practices for selecting the accurate codes and delivering timely claims for high reimbursement rates. With the help of billing and coding professionals, practices can adopt new systems and processes for collecting clinical and financial information up front, which will guarantee payors have all data needed to approve a claim in a shorter time period.
Medical groups that wait until the last minute to work with the new ICD-10 codes and test out best practices may suffer revenue loss once the transition takes place in October 2014. Because the ICD-10 system forces healthcare providers to be more specific when defining procedures and diagnoses, payors will be able to respond to claims more efficiently when filed correctly. Claims that are filed incorrectly, however, may miss payor deadlines and damage a group’s bottom line.
Furthermore, medical groups are adopting new technologies to assist with the ICD-10 transition that likely come with a learning curve as clinical and administrative staff adjusts their daily routines. All staff must work together to ensure the proper codes are being used and filed, and the guidance of expert professionals will only accelerate the learning process associated with new technology.
What To Expect With Prep
The American Health Information Management Association has outlined some steps all healthcare providers should take when planning and preparing for the ICD-10 transition. The changeover can be significantly accelerated and more easily worked into daily practice when clinicians partner with medical billing and coding experts. When creating a strategy for the ICD-10 transition, consider breaking up the process into four phases:
- Develop a plan and assess what impact the new coding system will have on day-to-day operations.
- Initiate the first phases of preparation such as selecting coding and billing experts to work with and launching education initiatives.
- Test the ICD-10 system in real-time through hands-on application with actual patients to work out kinks and errors.
- Assess the effectiveness of the trial run and review best practices for official launch in 2014.
The AHIMA warns that waiting too long to launch the four phases and not allowing ample time for each step could jeopardize revenue cycle success in October 2014. Medical groups left unprepared or still working through transitional pains risk claims rejections and payment delays.
Practices that lack the internal know-how and resources to properly plan for and implement the ICD-10 coding system can save valuable time and money by working with medical billing and coding professionals. Many of our clients have sought our expertise to guide them through the changeover experience and prevent common pitfalls from disrupting revenue cycles.
