With ICD-10 taking effect on Oct. 1, 2014, it is not surprising that the term has been Google-searched about 110,000 times during each of the recent months. Concern around the change is mounting, and if your practice isn’t ready for this transition you risk losing reimbursement and your practice could take a very large financial hit to its cash flow.
[See also: Was ICD-10 the year ICD-10 stood still?]
There is no shortage of resources available to help ease the migration, but unfortunately it can be overwhelming and often confusing to sift through all of this information. However, a couple of common themes emerge from all of this advice, including the importance of planning for the changes to come and the need to evaluate the systems that you’ll use before, during and after the compliance deadline. The following tips will help you simplify the process of gearing up for the switch to ICD-10.
Don't delay. It seems obvious, but procrastination may be one of the biggest threats associated with the move to ICD-10. As a result, nearly all ICD-10 resources emphasize the importance of planning for the code change – from determining the amount of budget you’ll need to investing in systems and staff training, arranging for any system implementation and anticipating the potential revenue impact to your practice during the changeover.
Contact your technology vendors. If your practice is using an electronic medical records (EMR) system, practice management (PM) system or other billing systems, contact the individual vendors and ask about their plans and preparedness for ICD-10. Some important questions to ask include:
- Will your documentation workflow be specific enough for ICD-10?
- What is your ICD-10 implementation timeframe?
- What does the implementation process involve?
- How will the systems work with both ICD-9 and ICD-10 codes?
- What type of training and resources will you provide, and what will be the cost?
- Does the system algorithmically choose an ICD-10 code, rather than providing an interface requiring the user to search and identify the code?
Talk it through. Communicate with your HIT vendors early and often to ensure that you understand their readiness and that you have all the information you need. You may also want to inquire about how your other service providers, such as coders and claims clearinghouses, plan to transition to ICD-10 and how that may affect your practice’s plans. ICD-10 has many moving parts, so you’ll want to ensure that all of your technology vendors and partners are moving forward with a clear and synchronized plan.
Always consider workflow. If your practice has an EMR system in place, understand whether that software will automatically assign the exact ICD-10 code to a diagnosis, or if you’ll need to select from a range of codes during or after the patient visit. Because of the specificity and long list of choices for the new code set, manually selecting from a range of choices will likely slow down your documentation at the point of care, leave you more vulnerable to choosing the wrong code and ultimately negatively affect workflow. As any physician in private practice knows, margins are thin, and if your EMR requires manual searches to identify ICD-10 codes, you might lose a minute or two per patient visit. In the long run this can have a significant impact on patients seen per day and the bottom line.
[See also: 3 ways to ensure efficient EHR workflow]
Think of the big picture. Instead of viewing ICD-10 as a box to check on a seemingly endless government compliance “to do” list, consider ideas to shift the challenge into a strategic opportunity for your practice. With a bit of research, you'll find new technologies that can automate the complexities of managing the ICD-10 transition for you. Select a solution with an intuitive coding system that will automatically assign your documentation to the correct, specific ICD-10 code. Leverage technology to take the manual steps out of the coding process.
Establish an adaptable framework. A solution that is built on an elastic platform model, like the cloud, and backed by agile support can also help your practice to keep up with constantly shifting and evolving compliance standards.
ICD-10 will be a major shift for physician practices in 2014, and while change of this magnitude can be daunting, a well-planned transition to ICD-10 actually represents a significant opportunity. It will be essential to educate and prepare staff for the deluge of new, highly specific codes and develop appropriate workflow adjustments. As adoption of EMR and PM systems continues to soar, it will also be important to ensure that any existing or prospective technology will support the new codes and also minimize workflow interruption.
The bottom line is that ICD-10 will ultimately affect your practice in either a negative or positive way, and it is up to you to make a plan and ensure that your technology vendors are onboard and capable of supporting your strategy.
Michael Sherling, MD, MBA, is co-founder and chief medical officer at Modernizing Medicine.
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