ICD-10: Final Preparation & What to Expect After Oct. 1

PRESENTED BY

Today’s Agenda

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Making the Most of Your Time

Ensuring Your Practice/Business is Ready

Identifying Payer Readiness

Handling Potential Issues After Oct. 1

Positive Impacts of ICD-10

ICD-10 Resources

Q&A/Wrap-Up

ICD-10 Countdown

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days hours minutes

0 5 0 9 5 3

Cara Buckhaulter, CPC Billing Services Operations Manager at NueMD

Today’s Presenter

Establish a team that includes members from all areas of your business including:

• Front Office Staff (Verification Specialist, Eligibility Checker)

• Nursing and Support Staff (MA, RN, LPN)

• Administrative Staff (Case Managers, Referral Coordinators)

• Providers (MD, DO, PA, NP)

• Billing and Coding Staff

• Finance Representative

Create a workflow for all processes that affect coding

and thoroughly test to ensure your process runs

smoothly.

Establishing an ICD-10 Readiness Team

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Have you contacted all of your Payers?

• When will they implement ICD-10?

• Will they have a dual coding submission period?

Establish a quick reference tool for Billing and Support

Staff where they can receive updates from Payers.

All Providers should be using the new CMS1500 format

and have paper claim forms on hand.

Utilize an ICD-9 to ICD-10 conversion tool, or have a

hard copy of the ICD-10 manual available for quick

reference.

Are You Ready?

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Are you aware of the major differences between ICD-9 and ICD-10 for your specialty’s top 25-50 diagnoses?

Is your entire staff at least familiar with ICD-10?

• New code format and the sets that make up the ICD-10-CM

• ICD-10 codes are 3-7 alphanumeric digits

• Digit 1 is always a letter

• Digit 2 is always a number

• Digits 3-7 can be a letter

or number

Are You Ready?

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Reminders for Front End/Billing/Coding Staff

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Review claims logs and other claim submission reports on a regular basis for rejections or complications.

• This is the best way to detect potential hiccups with Payers.

Verify Claims created by Interface partners have

passed over Diagnosis Codes correctly/completely.

Expect to see a slower revenue cycle as your team

learns and begins using the new code set.

Not all Payers will be ready to accept ICD-10 codes

• If you see an unfamiliar denial message, be sure to contact

the Payer directly for additional information.

Potential Issues

Be prepared for complications with…

• Payers

• Integrated Software Partners

• Clearinghouses

Issues you may experience include:

• Claim edits with Payers

• Appointment scheduling

• Correlation for lab testing, radiology, etc.

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Positive Impacts of ICD-10

As Payers phase out the use of unspecified codes, ICD-10 will allow for:

• Gathering of statistical data on patient populations

• Adjusting fee schedules to reflect a resource-related reimbursement method

Satisfy Meaningful Use Core Measures with ICD-10

Fewer requests for medical records to provide missing medical necessity.

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ICD-10 Resources

Road to 10: The Small Physician’s Practice Route to ICD-10

• Training

• Planning/Implementation

• Latest News from CMS

ICD-10 Resources

ICD-10 Basics – Video Series

• What is ICD-10?

• ICD-10 Format

• Anatomy and Physiology

ICD-10 Resources

ICD-10 Training Lab

• Code Search

• Codes by Specialty

• Training Games

Q&A