October 1 and full implementation of ICD-10 is just around the corner. The transition to ICD-10 is not just a simple update; it is a major revamping of diagnosis coding. With the complexity of coding using the ICD-10 system and the high risk of disruptions of workflow and reimbursement, robust education and widespread testing on all aspects of ICD-10 are crucial. By now, hopefully, your practice or your institution will have put a plan into motion and taken the necessary steps to ensure a seamless transition.
The ACR Practice Management and Coding office shares this checklist to make sure what you’ve done or are doing to prepare for ICD-10:
- Evaluate all clinical, financial, and business systems that currently use ICD-9 codes. This includes your practice management system, EMR, and encounter forms/superbills. Keep in mind that wherever ICD-9 is used currently in your practice, ICD-10 codes will take its place.
- Collaborate with practice management vendors, billing services, and payers to ensure that ICD-10 implementation is a priority for them and discuss implementation plans to ensure a smooth transition.
- Draft a budget that adequately covers changes to business processes, changes to software systems, and staff training. It is important to assess staff training needs, as coding and guideline changes in ICD-10-CM for rheumatic conditions may require coders to learn new terms and look for additional information in documentation to reach the highest level of specificity in the code set.
- Identify potential changes to workflow and business processes. Consider changes to existing processes, including clinical documentation, encounter forms, and other requirements for quality health reporting.
The ACR/ARHP Annual Meeting will include a pre-meeting course, ACR Advanced Rheumatology Coding and Clinical Documentation Improvement, on Friday, Nov. 6, from 9:00 AM – 5:00 PM. This hands-on coding workshop is designed to teach rheumatologists, practice managers and rheumatology coding professionals how to become proficient in the procedural and diagnosis coding system. Course attendees will focus on clinical documentation improvement efforts as they relate to coding for medical necessity in services rendered, as there is greater detail in the coding specificity for ICD-10. An overview of trends in denials and how to track and handle rejected claims will be provided. In an effort to manage and prevent reimbursement delays, presenters will assist attendees with business processes on submitting or resubmitting claims properly, tracking days in accounts receivable, and ICD-10 denial management.
For questions on ICD-10, contact Antanya Chung, ACR Director of Practice Management, at [email protected].