How to Stop Herding Cats and Start Gearing Up for ICD-10
Save the Date! ICD-10 goes live on October 1st, 2013, 2014, 2015! The third time’s the charm!
Now that there’s a new compliance date, you may be wondering what’s next. This is the time to take action and start testing not only your claim files, your whole process. A large focus has been placed on the changes coders will be facing, but coders are only as good as the information they receive and the knowledge and tools they have at their disposal.
5 Steps to Prepare for ICD-10
- Speak with your hospital to see what changes, if any, they have in store for collecting and transmitting newly required pieces of information.
- Check with your billing software vendor about testing options and how you will manage the ever-present payer specific requirements you encounter when there is a change.
- Verify with all of your vendors their capability to handle the format differences and capture new diagnosis data elements required for accurate coding in ICD-10.
- Plan for the increased number of appeals and follow-up items this will cause.
- Test, re-test, and test again.
If you’ve started testing, congratulations! You are well on your way. If you haven’t started testing yet, don’t worry – there’s still time, and we’ve outlined some helpful resources to guide you in formulating your plan.
While it may seem obvious to some, all practices must verify they are compliant when submitting ANSI 5010 claim files. Perhaps some eyes are rolling at this obvious statement, but there are some providers’ currently submitting ANSI 4010 files without being aware they are still submitting version 4010. How could this happen, you may ask? Most likely their clearinghouse offered the service to up-convert 4010 to 5010 and they never encountered issues with rejections due to an incorrect format, leading to the assumption, they must be compliant. The implementation of ICD-10 is predicated on the format of the 5010 file structure, so ensuring you are filing a 5010 format is a must.
Once you’ve verified your claims format, finding the next place to start can be a daunting task. Being overwhelmed and wondering if you are covering all of the areas of impact can seem as manageable as herding cats. Just typing “ICD-10” into the search engine on a computer will bombard you with pages of information, and much of it is either outdated or not applicable.
IMAGINE has a solution to help with the conversion. IMAGINE Conduit, a revolutionary application will assist your practice with the ICD-9/ICD-10 transition. Conduit is designed to help further prepare users for the scheduled October 1, 2015 switch to ICD-10 diagnosis codes by creating a crosswalk for converting electronic 837 claim files that utilize current ICD-9 codes to 837 claim files that utilize new ICD-10 codes. By taking an ICD-9 HCFA and adapting it to an ICD-10 HFCA with minimal human intervention, practices with older technology can better survive the upcoming switch.
CMS has released a great deal of information regarding the move to ICD-10, and to help with the transition, they’ve launched “Road to 10”; a practical website, giving users specifics on the whole process including a template for you to build your own transition plan. The transition is broken down into 5 categories: “My Specialty”, “My Practice Size”, “My Technology & Staffing Partners”, “Your Trading Partners” and “My ICD-10 Readiness”.
How to Build Your Transition Plan Using “Road to 10”
Select “Build Your Action Plan” option on the home page of the site,
select your specialty, and choose your options.
Once you’ve made your selections, a timeline will be generated for the different areas
of impact and general information available for each shown below the timeline.
You can drill down into each section for more detailed information and
ideas/questions for planning your transition.
The bottom line is the more effort you put into your readiness now, the less likely you or one of your staff members will be labeled with a diagnosis of F48.8 - Occupational Neurosis.
Procrastinate not my friends; the end is near….or at least until the next delay is announced.
Road to 10; http://www.roadto10.org/
About The Author
Brandy has been with the IMAGINE team since 2005 and serves as a Client Success Manager where she enjoys helping clients use medical billing technology to effectively manage their practice.