All health care services and discharges provided on or after October 1, 2014 will be required to use ICD-10 codes.The implementation of ICD-10 is more than a technical project. There are business implications of implementing ICD-10 that will impact most areas of your practice, including documentation and coding. The Centers for Medicare & Medicaid Services (CMS), the agency in charge of enforcing compliance with ICD-10, has identified claims processing interruptions as a high-risk possibility. Practices need to ensure they have implemented ICD-10 prior to the deadline to avoid disruptions in their cash flow and claims reimbursement.
We will help you with:
1. Organize the implementation
Overall project planning, Identify key personnel, Preliminary budget planning, software upgrades, hardware upgrades, training, and communication planning
2. Impact analysis/System study:
Identify possible work flow changes, like superbills, encounter forms etc
Identify and list all work processes that use ICD-9 today
Identify and list current electronic systems (e.g., practice management system) that use ICD-9
Determine which code sets you need to implement, ICD-10 diagnosis only or both the diagnosis and procedure
Identify all staff who work with ICD-9 and exactly what they do related to ICD-9 and ICD-9 coding
3. Update impacted systems
Update any internal processes, electronic or manual, used to conduct administrative transactions, e.g., submit claim, check eligibility, etc. Update data collection tools and forms, e.g., encounter forms, superbills, etc.
Update processes for writing orders, referrals, clinical reports, etc. Update other processes for clinical data, e.g., problem lists, disease management registries, etc. Complete a review of existing documentation for orders, referrals, and reports and compare it to the clinical details needed for ICD-10.
4. Internal testing
Conduct internal testing to ensure you can generate transactions with the ICD-10 codes within your system (This will serve as a "dry run" within your own walls to ensure your system is capable of handling the ICD-10 codes).
5. External Testing
Conduct external testing with your trading partners to ensure the ICD-10 codes are sent and received properly
6. Implement new set of codes
Begin using ICD-10 for reporting services performed on or after October 1, 2014.
7. Monitor submissions/Receipt
Monitor submission and receipt of ICD-10 codes to ensure they are being received properly. Monitor payments to ensure they are the expected amounts for the service(s) provided.
8. Contact system vendors
Contact your system vendors and trading partners (Clearinghouses, Healthplans, Billing services). This step should be performed upfront.
9. Staff training
Identify super users, clinical staff, coders etc to be trained.