Power Through the ICD-10 Transition

Written by: Kimberly Commito on Tuesday, June 9, 2015 Posted in: HME/DME, Home Infusion, Specialty Pharmacy

clock-01new_ddbfab4e6f521a28e1530b3687d03087While rumors are always swirling that ICD-10 implementation will once again be delayed, operationally, you have to continue to move forward and plan for conversion on October 1st , because literally the clock is ticking.

However, two bills currently in Congress may potentially affect implementation. The first, known as the Cutting Costly Codes Act of 2015 (H.R. 2126), reintroduced by Rep. Ted Poe (R-Texas), would prohibit the implementation of ICD-10 altogether. And this bill has the backing of incoming American Medical Association President Steven Stack, who told Healthcare Finance, “We believe the problems associated with ICD-10 are so substantial [that] we should not move forward with [it].” Instead, he added, “Let’s just get to ICD-11, and get it done properly.”

The second bill, sponsored by Rep. Diane Black (R-Tenn.), is known as the Increasing Clarity for Doctors by Transitioning Effectively Now Act (ICD-TEN Act). This bill would “require 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.”

Nevertheless, as a provider, you should be forging ahead with your organization’s implementation. Operationally, you should already have a project team in place and a project plan identifying your timeline, areas of responsibility for members of the project team and a training plan for the remainder of your staff. Your team should also be reviewing your current process flow to determine if changes are needed.

If your organization employs clinical staff, you should ensure that they are a part of your project team. Many ICD-9 codes do not have a direct, one-to-one link to ICD-10 codes. This will require scrubbing through your clinical documentation to determine the correct ICD-10 code or having staff spend hours of time on the phone calling physician’s offices to get the correct codes. Both of these processes could adversely affect your cash flow in October if you are not prepared.

But if you are using a Mediware home care solution, ICD-10 code management tools are built in, so the transition will be manageable. For more information on the clinical aspect of the coding and relationships between ICD-9 and ICD-10, please see the upcoming article from Kay Overby, RN, BSN.

Finally, take the opportunity to submit test claims if you haven’t done so already. The final week for testing with Medicare is right around the corner in July; however, you should be able to submit test claims through your clearinghouse at any time. While most software providers and clearinghouses have already successfully submitted test claims, providers are strongly recommended to test as well.

For more in-depth information about getting ready for ICD-10 implementation, view Mediware’s ICD-10 Resource Center: https://www.mediware.com/icdten

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