The path to transitioning to ICD-10 to minimize practice disruptions and claim denials will not be easy. We reached out to ZirMed to ask them to give us some tips to help providers make a successful transition. You can check out their nine tips below and hear them throughout the day playing on the station.
Set up a system ahead of time to evaluate how the new code set is affecting your organization’s workflow and revenue in the days following go-live. No matter how well you’ve prepared for ICD-10, chances are you’ll find that some things aren’t going as smoothly as you’d hoped. It’s important to identify those areas as quickly as possible so you can take corrective action. So plan to track your organization’s real-world performance and look for ways to improve it.
Decide which types of denied claims to focus on and which to let slide. ICD-10 is expected to increase denials significantly. It’s unlikely your staff will be able to appeal every one, at least in the first few weeks. Figure out now which types of denied claims will have the biggest impact on your bottom line…and which ones can be appealed with the highest success rates. Then make sure your staff works on those first, and only moves on to others if there’s time left over.
Create a master list of ICD-10-related assignments and responsibilities for everyone in your organization…and make sure everyone is familiar with it ahead of time. After ICD-10 goes live, the last thing you need is people waiting to be told what to do…
or trying to figure out who’s responsible for what. A written list of assigned responsibilities can make things go much more smoothly…and reduce finger-pointing and frustration.
Set up a more effective system for managing and appealing denied claims now. Don’t wait for October 1st, when denial rates are expected to skyrocket. Look for a denial and appeal management software application that automates the entire process of managing and appealing denials…and gives you the information you need to prioritize work and track staff productivity. Choose a comprehensive denial and appeal management program that’s cloud-based, so it’s always up-to-date with the latest payer requirements. And be sure it provides auto-populated payer-specific electronic forms, then prints and mails them on your behalf.
Create a list of the most commonly used diagnoses in your organization, and include the correct ICD-10 code—or codes—for each of them. Then send copies to your physicians and coding staff. Ask them to read it through now, then use it for quick reference beginning on October 1st. It’s an easy, low-cost way to save time and reduce errors when ICD-10 goes live.
Use cloud-based software to find the right ICD-10 codes quickly. ICD-10 has 68,000 codes—over 5 times as many as ICD-9. After go-live, you don’t want to be flipping through lengthy code books or toggling between different programs to find the right codes. So don’t wait for October 1st to purchase an automated coding tools product. Choose one that makes it easy to check for invalid code combinations, search for and confirm the appropriate ICD-10 codes, and find the correct modifiers.
Schedule fewer appointments the week before and the week after October 1st. The week before go-live, your staff will need plenty of extra time to prepare. And during the first week of October, physicians and coders will need extra time to meet the increased specificity requirements of ICD-10 and select the correct codes. A lighter appointment schedule than usual will give them the added breathing room they need to minimize delays and errors.
Make sure all of your software systems and documentation is ICD-10-ready. That includes your PM, EHR, patient access, and claims and AR management software. Check with your vendors to verify that all of the applications you use are ready for ICD-10, then make sure you’re running the latest versions. Using cloud-based software that runs in a browser ensures that your applications are always up-to-date. But if you’re running any software that’s installed on your own hardware, check to see whether there are newer versions available…then get them installed before October 1st.
Know when to use unspecified ICD-10 codes—and when to use specific ones. ICD-10 has over five times as many codes as ICD-9, and provides much greater specificity. Don’t be tempted to use an unspecified code simply to avoid looking for an unfamiliar specific code that more accurately describes the condition. But don’t use a specific code when there isn’t enough documented clinical information to support it.
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