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Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Superbill and Forms Revision for ICD-10

Superbill and Forms Revision for ICD-10 | EHR and Health IT Consulting | Scoop.it

The ICD-10 implementation date is just four short months away. Physicians must ensure that their forms, including their superbills, are ready for the conversion on Oct. 1, 2015.


Superbill Revision


Many physician practices use a superbill to account for the services rendered (CPT codes) and patients' diagnoses (ICD-9 and ICD-10 codes). These forms must be updated on a regular basis to reflect any code changes. The conversion to ICD-10 will require a major overhaul of the superbill. Each ICD-9 code that is listed on the existing superbill will need to be converted to the related ICD-10 code. There is not always a 1:1 match when translating an ICD-9 code to an ICD-10 code. In fact, due to the greater specificity in most areas of ICD-10, there could be several ICD-10 codes that map back to just one ICD-9 code.


CMS' website provides a list of the mappings of ICD-9 to ICD-10 codes called the General Equivalence Mappings (GEMs); view it here: bit.ly/CMS-GEMs. This tool is helpful as a first step for practices to compare the commonly used ICD-9 codes to the related ICD-10 codes. However, the user must keep in mind that these GEMs are not a crosswalk. The full list of ICD-10 codes, including coding guidelines and conventions, must be reviewed to determine the appropriate code assignment.


Since the list of ICD-10 diagnosis codes a practice utilizes could be quite extensive, the use of a superbill for diagnosis coding might need to be reevaluated. There are other solutions, such as the use of EHR, which would better assist physicians in selecting appropriate codes.

It's also important to remember that the physician documentation within the record (outside of the superbill), must justify the services provided and fully describe the patient's diagnoses. The superbill does not stand on its own for coding and billing purposes.


Other Forms Revision


Besides the superbill, there may be other forms that will need to be revised in anticipation of ICD-10. Physician practices should take an inventory of all forms currently used, whether paper or electronic, and review them for ICD-9 codes. Any forms that currently include ICD-9 codes will need to be refreshed with ICD-10 codes.


Some areas that may currently include ICD-9 codes are patient scheduling and registration, documentation templates within the EHR, coding and billing forms, and external reporting/databases. Once these impacted areas are identified, it's essential to communicate any required changes to the forms with the affected parties to ensure readiness for the ICD-10 conversion.


EHR Readiness


Most physicians use some type of EHR within their practice. It is essential that the EHR is ready for the conversion to ICD-10. If the practice has purchased an EHR from a vendor, a readiness assessment should have already been completed several months ago for ICD-10. However, if this process has not been done, practices should contact their EHR vendor immediately to ensure that it will be compliant with ICD-10 on Oct. 1, 2015.


Some practices have created their own "home-grown" EHR which will also need to be evaluated for ICD-10 readiness. Physicians and their coding staff should practice assigning ICD-10 codes within their EHR system to ensure that the system is capable of accepting these codes. It's important to remember that the current ICD-9 codes are between three digits and five digits, whereas the ICD-10 codes are between three characters and seven characters.


Many EHRs have built-in documentation templates that physicians use to assist with capturing the complete clinical picture of the patient. These templates may need to be revised for ICD-10 as well.


Next Steps


Leading up to ICD-10 implementation, a physician practice should have already created an ICD-10 communication plan, developed a budget, completed staff and physician education, performed readiness testing, analyzed documentation, reviewed quality reporting requirements, and revised superbills and other forms. Use these remaining four months wisely to ensure a smooth transition on Oct. 1, 2015.

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ICD-10 Isn’t Getting Credit it Deserves

ICD-10 Isn’t Getting Credit it Deserves | EHR and Health IT Consulting | Scoop.it

Twice in recent weeks, legislation regarding the transition to the ICD-10 coding set has been introduced into the U.S. House of Representatives. One proposed bill would potentially “prohibit the Secretary of Health and Human Services from replacing ICD-9 with ICD-10,” while the latest one is less drastic, and pushes for a required ICD-10 transition period following implementation on Oct. 1, 2015.

It remains to be seen if either of these bills will gain any traction, and generally speaking, there seems to be mixed reactions from industry stakeholders and the medical community on the value of ICD-10. Recently, an exclusive survey done by Healthcare Informatics, in conjunction with QuantiaMD, a Waltham, Mass.-based social network for physicians, found that doctors—many of whom have come out against ICD-10—are not backing down in their distaste for the mandate.


However, according to members of the Washington, D.C.-based consulting firm The Advisory Board Company, it’s time for the transition to finally happen. Specifically, Piper Su, vice president of The Advisory Board Company’s health policy division, says in regards to the proposed bills, “While a few members of Congress continue to voice concerns about the health system’s readiness for ICD-10, what we see this year is more widespread consensus amongst policymakers that the time has come to move forward.  The previous delays, combined with early results from end-to-end testing, alleviated some concerns that providers have not been given enough time to comply and are not ready to meet the deadline,” Su says. “Lawmakers are now coming to conclude that no amount of time will yield a perfect transition, so Oct. 1, 2015 may be a fair date for moving forward.  However, we expect concerns about the transition to continue, so we also anticipate that there will continue to be close scrutiny as we get closer to that date,” she adds.


What’s more, Ed Hock, managing director at The Advisory Board Company, says that the ICD-10 transition will benefit healthcare providers and patients and that another delay isn’t in the best interests of anyone. Hock says that providers need to prioritize efforts over the next few months to reduce risk. During his time as managing director at The Advisory Board Company, Hock has worked with more than 100 hospitals and health systems specifically on their transition to ICD-10, and focuses mainly on such provider organizations. He recently spoke with HCI Associate Editor Rajiv Leventhal about the industry’s current level of readiness for ICD-10, best strategies to reduce risk, and a key point that provider organizations are overlooking regarding implementation. Below are excerpts of that interview.


How would you rate the industry’s readiness for ICD-10?


Most of the industry is well on the path to readiness. We have seen that the amount of time has been a huge blessing to many providers, and we are also seeing providers—in the last 60 days especially—really accelerate their preparation once we got past the Sustainable Growth Rate (SGR) fix. That’s when things kicked into overdrive across the country. Now is the time for additional end-to-end testing, and the exchanges of data files will prove out if what we’re seeing is really the case. We’re just starting to see that play out though. Overall, [providers] are on a good path. 


Is the level of testing that’s going on right now thorough enough?

The level of testing varies widely from provider to provider. I was sitting with a dozen CFOs yesterday, and some of them in the room have tested thousands of files from a double coding perspective as well as exchanging with their payers. Overall, most were pleased with the results, but there is still interesting learning occurring. One provider said they were getting higher rates than they expected, positive results with payers, and all claims were going through. They realized some of the claims were going through ‘too smoothly,’ if you will. So that’s the type of learning we will uncover as we get closer.  Not just can you exchange claims, but are claims going to get denied that should or shouldn’t be? How will the real dynamics of coding and revenue cycle play out?


So how do you see this playing out?


Of course there will be some trouble; we feel the well prepared organizations will minimize most of that trouble. There are a number of things that can go wrong from the policy being adjudicated incorrectly or misunderstood, or coders not fully understanding all of the guidelines, or physicians not knowing all the documentation rules they need to follow. So even organizations that have their systems tested should look beyond that to ask themselves, ‘Are all my people who touch ICD-10 codes trained? Have we practiced, and made sure the work product that comes out of those tasks is acceptable as well?’

With dual coding, so many organizations say they are starting to dual code or already have, but the much more interesting questions are the second and third level questions on those dual claims. What type of reimbursement impact are you seeing, or what type of denial rates would you expect on those claims? Either those answers aren’t satisfactory or many providers haven’t yet asked those questions—they are still in the ‘figuring out’ period.


What are some of the best strategies you’re offering your clients to “reduce risk”?


Most organizations have done some aspect of this, but it’s again about looking across their hospital or health system and understanding every single area where ICD-10 codes come into play, understand and rank the risks in terms of impact to the organization, and then mediate and test each of those going forward. Also, at this stage especially, ICD-10 readiness needs to report up to the highest levels of the executive team. The CFO is the correct best practice in terms of who to report to. CIOs and HIM directors are part of the plan, but often don’t have a complete perspective of the financial side, or the ability to take urgent action if something is off track or not at the level it should be at.


There’s also some more forward-thinking stuff. I think something that’s overlooked is what will October 2 and beyond look like? You need to be able to quickly read, react, and adjust from there. For example, every hospital has a dashboard of financial metrics they follow. How quickly are they billing for the services they provide, and how long does it take to get paid for those? Those numbers will go through big periods of fluctuation; denials will go up, revenue will go down. So each organization should have to have an agreed upon, sophisticated plan. What are my acceptable levels and what is my trigger or plan to enact if one of these things goes above my acceptable level? What is the level where someone says we have to step in, whether that’s leadership team or outside help, to put that fire out, and readjust from there? Some of the metrics on that dashboard are based on benchmarks that are purely ICD-9 based, on the language we have used for the last 30 years. Organizations have to have a way to measure those things going forward. How does it compare to my peers, up or down? Hospitals are working to share their data back and forth, and that’s something we’re working on here at The Advisory Board.


Do you think organizations are thinking about post-October 1 as much as they should be?


Well, I think most providers are so focused on the here and now; they’re missing arguably the most important part, the post-ICD-10 transition. At a certain point in the next couple weeks, the plans that have been made are all we can do. You have to execute on those. If you think about any disruptive event in healthcare such as mergers or a new operating system, it’s about the planning beforehand, but also the leadership, execution, and planning how to deal with the inevitable is crucial. Even for those who aren’t as prepared as they thought they might be, a great leadership team and a plan to adjust quickly if something does happen will go a long way.


Overall, are providers on board with understanding the value of ICD-10?


I see it all over the place—there is a huge spectrum of people loving it and hating it. From a policy perspective, ICD-10 is not getting the credit that it deserves. If you think about where healthcare is going, it’s about understanding the value that’s been provided in the service that’s been rendered, and understanding the tradeoffs between higher value and higher cost. The fact that our current coding system doesn’t capture the approach in common procedures is a real fallback for organizations that are trying to make decisions on providing the best care at the lowest cost. It serves a valuable cause, and I think people do miss that.

With the granularity of all of the new codes, is there a way to make sense of it all in an easier way?


I think people get lost in the funny codes, such as ‘struck by turtles,’ but if you think about it from a ‘what do we want to really know about our patients?’ perspective, it makes sense. Why something happened is a really important aspect. We took an approach, we took all of these thousands of codes, and broke them down into the fewest clinical concepts that a physician has to learn in order to appropriately document. The number of new concepts is staggeringly low. For a fracture of a hand, for instance, it goes from 40 codes to something like 1,800, but there are actually only four new clinical concepts that a physician needs to know and include. And those four concepts are something that every doctor would tell you are medically important and easy to include in his or her notes. People go crazy over the 1,800 codes, but the narrative doesn’t tell the real story. It’s funnier to read a story about the crazy codes.


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Bill Mandates Transition Period During ICD-10 Implementation

Bill Mandates Transition Period During ICD-10 Implementation | EHR and Health IT Consulting | Scoop.it

Healthcare providers who are preparing for the ICD-10 implementation starting on October 1 may be offered an ICD-10 transition period as well. A new House of Representatives bill H.R.2247 called Increasing Clarity for Doctors by Transitioning Effectively Now Act (ICD-TEN Act) mandates the “Secretary of Health and Human Services (HHS) to provide for transparent testing to assess the transition under the Medicare fee-for-service claims processing system from the ICD-9 to the ICD-10 standard, and for other purposes.”


The bill was issued by Representative Diane Black (R-TN-6) on May 12. The bill does not seek to delay the ICD-10 implementation period nor does it ask for there to be a dual coding system incorporating both ICD-9 and ICD-10, according to the Journal of AHIMA.


The bill asks for the Department of Health and Human Services (HHS) to conduct end-to-end testing among all providers to ensure that their Medicare fee-for-service claims system is working effectively and is compliant with the ICD-10 codes.


The ICD-10 transition period would take place over 18 months after which HHS would send a report to Congress stating whether the ICD-10 implementation is successful and not blocking the provision of provider claims. Essentially, the Centers of Medicare & Medicaid Services (CMS) would need to show that they are processing and approving the same amount of claims as in previous years under the ICD-9 coding set. The bill also states that if the ICD-10 implementation is not considered “functional” at that point by Congress, HHS would need to develop more methodology to ensure that the new coding set is working properly in the near future.

“During the ICD-10 transitional period, it is essential for CMS to ensure a fully functioning payment system and institute safeguards that prevent physicians and hospitals from being unfairly penalized due to coding errors,” Black wrote in a letter to Congress.


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How Can Providers Prepare for the ICD-10 Transition Deadline?

How Can Providers Prepare for the ICD-10 Transition Deadline? | EHR and Health IT Consulting | Scoop.it

Even though the latest legislation set forth by Representative Ted Poe (R-TX) calls for slashing the movement toward ICD-10 coding completely, there is little evidence that his bill will be taken seriously by the Committee on Energy and Commerce and the Committee on Ways and Means. In 2013, Poe introduced a similar bill into the House of Representatives and it was disregarded by the two committees.


As such, it is more likely than not that the ICD-10 transition deadline will continue as planned. What does this mean for healthcare providers? What steps should medical organizations be taking to prepare for the ICD-10 transition deadline?


ICD-10 Testing Recommended


For one, providers can still conduct acknowledgement testing with their local Medicare Administrative Contractor throughout the coming months up until the ICD-10 transition deadline of October 1, 2015. Ensuring that a basic claim using ICD-10 coding can be effectively accepted by the Centers for Medicare & Medicaid Services (CMS) is imperative in preparing for this transition.


Additionally, CMS is hosting an acknowledgement testing week in June during which providers can gain extra assistance from the help desk. External testing is also encouraged and many clearinghouses along with payers are ready to conduct ICD-10 tests with the provider community.


Education and Training Vital Among Hospital Staff


In order to fully move over to the new coding set and be prepared for the ICD-10 transition deadline, doctors and the rest of the hospital staff will need to be trained on utilizing ICD-10 codes correctly. Hospital CIOs will need to determine the level of education each individual staff member will need. Clearly, billing staff, front desk administrators, managers, nurses, and other healthcare professionals will need adequate training before transitioning to the ICD-10 coding set. Some will need basic education and others more in-depth training while some will need to know documentation-centered coding.


Prepare IT Systems or Other Methods for Submitting New Claims

Providers should work with their EHR vendors to ensure all health IT systems are upgraded to the new ICD-10 coding set before October 1.  However, if there are any glitches in their IT systems and providers are unable to submit new claims using the updated codes, CMS encourages providers to download free billing software from their Medicare Administrative Contractor.


Additionally, about half of these contractors offer Part B claims submission through an Internet portal, which gives providers another avenue to file claims with ICD-10 codes. Along with these options, providers who have an Administrative Simplification Compliance Act waiver are actually able to submit paper claims. Nonetheless, CMS encourages providers to prepare their IT systems and submit electronic claims if possible.


“Compared to the 9th revision of the ICD codes (ICD-9) currently in use, ICD-10 codes allow for greater specificity in describing patient diagnoses and in classifying inpatient procedures,” stated Orrin G. Hatch (R-Utah), Chairman of the Committee on Finance. “The transition to ICD-10 codes requires both CMS and covered entities to develop, test, and implement information technology systems that can process the new codes. In addition, these covered entities need to educate and train staff in using these new codes, and may need to modify internal business processes.”


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ICD-10 Implementation Vital for Value-based Care Payments

ICD-10 Implementation Vital for Value-based Care Payments | EHR and Health IT Consulting | Scoop.it

When the SGR bill was passed by the Senate without any ICD-10 implementation delays, the proponents of the new coding set rejoiced. Not only did passage of this bill bring about a stronger formula for Medicare reimbursements but it also meant that the ICD-10 implementation would most likely take place by the scheduled deadline of October 1, 2015.


When President Obama signed the Medicare Access and CHIP Reauthorization Act of 2015 into law on April 16, the legislation moved American physicians away from fee-for-service payments toward value-based care and accountable care delivery, according to the Healthcare Information and Management Systems Society (HIMSS).

Additionally, the new SGR bill includes innovative objectives for establishing the meaningful use of certified EHR technology. These payment models will be key for improving population health outcomes throughout the country. The volume-based payment reductions under the prior sustainable growth rate formula will now be altered with a new annual payment update of 0.5 percent through 2019.


By 2019, doctors will be able to choose their reimbursement method among two options: the Merit-Based Incentive Payment System or the Alternative Payment Model. While the Merit-Based Incentive Payment System will depend upon the performance of physicians, doctors who choose the Alternative Payment Model must utilize certified EHR technology standards and authorized quality measures as well as assume financial risk.


The overall push toward value-based care among the federal government, patient advocacy groups, and healthcare providers will require the medical industry to quickly and efficiently transition to the ICD-10 coding set. Documenting patients’ medical histories as well as accurately reporting and coding diagnoses and treatments is vital in the quest to pay for value and enhance population health outcomes across the sector.


The Coalition for ICD-10 also reports on the importance of the ICD-10 implementation in the move toward value-based care, as ICD-9 codes do not have the same capabilities as the newer coding set. While the healthcare community supports the SGR reform bill, many physician groups are still against the ICD-10 implementation and are hoping for additional delays.


However, a move toward measuring and paying for value-based care is not possible without transitioning to a modernized form of diagnostic and procedure coding. In order to accurately measure the value of a healthcare service, it is vital to have the detail available in the ICD-10 coding set, the coalition explains.


One example of the subpar quality of ICD-9 codes involves putting two patients with similar conditions but differing symptoms under the same code while ICD-10 accounts for a variety of divergence among patients. Essentially, ICD-10 codes will include key information about patients and record their medical history more accurately with additional detail.


“Despite opposition to ICD-10 by some physician groups and a few isolated state medical societies, there is general recognition in the medical community that a modern and precise coding system like ICD-10 is essential for measuring and paying for value,” the Coalition for ICD-10 stated. “ICD-9 represents medicine of a bygone era. It cannot support a move to measuring and paying for value. To meet the demands of SGR there can be no further delays in the ICD-10 implementation date.”


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Will ICD-10 Compliance Deadline Affect Hospital Payments?

Will ICD-10 Compliance Deadline Affect Hospital Payments? | EHR and Health IT Consulting | Scoop.it

The ICD-10 compliance deadline is set to take place on October 1, 2015 as long as no legislation-based delays occur. The ICD-10 transition is bound to affect a variety of healthcare procedures especially billing and claims processing. On March 18, the ICD-10 Coordination and Maintenance Committee discussed how Medicare inpatient hospital payments will be affected after the ICD-10 compliance deadline.


Ron Mills, Software Architect for the Clinical & Economic Research department of 3M Health Information Systems, spoke about the impact of the ICD-10 transition. In particular, Mills discussed the effects of the transition on Inpatient Prospective Payment System Medicare Severity Diagnosis Related Group (MS-DRG) payments.

“We worked with 10 million fiscal year 2013 MedPAR records – the last year for which we have MedPAR data,” Mills began explaining the findings. “These represented about $100 billion of hospital reimbursement. Of those records, about 0.4 percent had a DRG shift to a higher paying DRG – that is one coded in ICD-9. They had one DRG coded in ICD-10 and a different DRG that had a higher weight and would therefore have a higher payment. Taken altogether, there was a 0.13 percent increase in payment for that subset of claims.”

“We can’t predict that there will be any change in our MSDRG hospital reimbursements just due to the fact that we’re moving from ICD-9 to ICD-10,” Mills mentioned.


In addition to Mills’ presentation, the Centers for Medicare & Medicaid Services (CMS) gave an overview of their testing plan for ICD-10 success. Stacey Shagena of the Medicare Contractor Management Group at the Center for Medicare discussed a four-pronged approach for ICD-10 testing.


Before the ICD-10 compliance deadline, CMS plans to conduct: (1) internal testing of its claims processing systems, (2) acknowledgement testing, (3) end-to-end testing, and (4) provision of beta testing tools to the provider community.

“Acknowledgement testing allows the testers to submit claims with ICD-10 codes to receive an acknowledgement that the claim was accepted,” Shagena stated. “This testing is a very high-level testing but it allows testers to know that their claim will be accepted into the system as properly formatted with ICD-10 codes. The testers do get an electronic acknowledgement that says their claim has been accepted.”


“We were successful and we did not find any systems issues with our March [ICD-10 acknowledgement] testing,” Shagena explained. “We have one future acknowledgement testing week left to participate with us during our specific testing weeks, which is the first week of June.”


Additionally, healthcare providers and payers may participate in acknowledgement testing with CMS at any point in time before the ICD-10 compliance deadline. The preparations toward the new coding transition including testing, training, and upgrading IT systems are moving ahead for many healthcare organizations. With only four and a half months to go before the ICD-10 compliance deadline, it’s vital for medical providers to be prepared to integrate the new coding set within their billing and claims processing systems.


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Physician Education for ICD-10

Physician Education for ICD-10 | EHR and Health IT Consulting | Scoop.it

With only five months to go until the implementation of ICD-10, the countdown is on for physicians, and other clinicians to be educated on the nuances of this new code set.

Breadth and Depth of Training


Training in ICD-10 is being offered by many different companies in multiple formats, such as online learning, face-to-face workshops, textbooks, or webinars. With all of these different options, the first step is for the physician to determine the depth of ICD-10 training needed. A few questions to ask:


• Will the physician be assigning codes in ICD-10?


• Does the physician have coding staff to assign the codes, but needs to be educated on the documentation requirements for ICD-10?


• Are there other clinicians in the practice, such as nurses, therapists, etc., that need training on ICD-10 documentation requirements?


Depending on the work flow of the practice, the physician may or may not be responsible for selecting the diagnosis code(s). If the physician is selecting the ICD-10 code, either on a superbill or within an EHR, a detailed course/training covering guidelines and conventions of ICD-10 may be in order. However, if the physician has coding staff that assign the diagnosis codes based on the documentation, the focus of training should be on the nuances of documentation for ICD-10.


The ICD-10 classification system includes many more codes than ICD-9, which at first may be daunting to the clinician. However, when taking a closer look, much of the expansion of the code set is due to the addition of laterality, which is hopefully already being documented. Clinicians who currently have high-quality documentation will likely experience a very smooth transition to ICD-10, with minimal documentation changes necessary.


Another factor to consider is the breadth of training. For instance, a cardiologist may only be interested in learning about diagnosis codes pertaining to the cardiology specialty, whereas a family-practice physician may want a more comprehensive training covering all body systems.


Training Modalities


After determining the depth and breadth of ICD-10 training desired, the next step is to look at the delivery mechanism. There is not a one-size-fits-all ICD-10 physician training program. Comparing and contrasting the different types may assist in selecting the best option.


Face-to-Face


Attending a workshop or hiring an expert to do the training is probably the quickest method; however, it could be the most costly. Many companies and individuals offer training in ICD-10, and some tailor it to specific needs, such as physician documentation requirements. Having an expert come to the practice to do the training allows for individualized, practice-specific training. One valuable exercise would be to have the expert trainer review the current clinician documentation and identify gaps in documentation that need to be remedied for ICD-10 readiness. This exercise of documentation analysis could even be done by an internal coding staff member that has received extensive ICD-10 coding training.


Online


The flexibility of taking courses online is attractive to many and the cost is typically lower than a face-to-face training. Busy clinicians may prefer to take an online course at their leisure, as time allows. However, finding an online course to meet a practice's individual documentation needs may be a challenge.


Webinars


Another form of training that doesn't require travel is webinars. Oftentimes, these webinars are recorded and may be viewed at any time, allowing for great flexibility for the time-strapped healthcare professional. Webinars are great for learners who like to both see and hear the material being presented.


Textbooks


Probably the least expensive option for training is to purchase a textbook from a reputable ICD-10 training company. Be sure to review the content of the textbook to determine if it is geared toward coders or clinicians. A textbook for coders may be too granular for the average clinician who needs assistance with documentation requirements, not coding guidelines.


Putting Training into Practice


Once the training is complete, the physician must practice what was learned. Many EHR vendors are offering the option to practice coding in ICD-10, which might be ideal for that clinician wanting to preview the codes and get a feel for the necessary documentation. If the physician is working in a practice that has coders assign the codes, then the physician should work together with the coder to ensure that the documentation in the record is specific enough for accurate ICD-10 code assignment. Ideally, physicians and coding staff should work together to ensure that the documentation is ready for Oct. 1, 2015.


Next Steps


A physician practice that has implemented an ICD-10 communication plan, developed a budget, completed staff education, performed readiness testing, analyzed documentation, reviewed quality reporting requirements, and is working on physician education on ICD-10, is on a positive pathway to implementation. Oct. 1, 2015 is quickly approaching and time must be used wisely.


7 Big Changes for ICD-10


Focus on the most frequently used codes at your practice — such as these seven — to better prepare your primary-care practice for the ICD-10 code set transition.


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Small Practices Aren’t Ready for ICD-10

Small Practices Aren’t Ready for ICD-10 | EHR and Health IT Consulting | Scoop.it

Many healthcare professionals continue to think that there should be no transition to the ICD-10 coding set, according to a new survey from NueMD, a Marietta, Ga.-based medical practice management software vendor.


NueMD's third "Attitudes Towards ICD-10" survey generated 1,000 responses from healthcare professionals across all 50 states. While the survey includes responses from medical practices, billing companies, and other industry professionals, the majority of respondents are from small practices.


The data suggests these small practices are less prepared and more concerned than larger organizations. The top response for questions about the new coding standards and the timeline for implementation was "There should be no transition to ICD-10." To help explain that sentiment:


  • 11 percent of respondents said they're "highly confident" their employees will be adequately trained by the current Oct. 1 implementation deadline, while 35 percent said "not at all confident."
  • 13 percent of respondents said they're "highly confident" their business will be prepared for ICD-10 by Oct. 1, while 31 percent said "not at all confident."


When asked about their concerns and expectations for different areas of their business:


  • 65 percent said they're "highly" or "significantly" concerned about claims processing.
  • 70 percent expect that finances will be affected "somewhat" or "very" negatively.
  • 70 percent also expect that operations will be affected "somewhat" or "very" negatively.


NueMD conducted similar surveys in 2012 and 2014. While there were some small positive changes in levels of concern, there weren't any major shifts over the last three years. Similarly, an exclusive survey recently done by Healthcare Informatics, in conjunction with QuantiaMD, a Waltham, Mass.-based social network for physicians, found that doctors—many of whom have come out against ICD-10—are not backing down in their distaste for the mandate.


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