The AMA recommends several steps to prepare for converting to ICD-10:
Explore this issue:September 2015
- Talk to your practice management or software vendor about whether the needed software updates will be installed with upgrades and when;
- Talk to your clearinghouses, billing service, and payers to determine when they will have their ICD-10 upgrades completed and when you can begin testing with them;
- Identify the changes that you need to make in your practice to convert to the ICD-10 code set (e.g., diagnosis coding tools, super bills, public health reporting tools);
- Identify staff training needs, and complete the necessary training;
- Conduct testing internally to ensure transactions with ICD-10 codes can be generated; and
- Conduct testing externally with clearinghouses and payers to make sure transactions with ICD-10 codes can be sent and received.
“Otolaryngologists should also look into the resources available to them through the specialty societies,” Dr. Denneny said. “For example, the Academy offers ICD-10 ENT super bills for AAO-HNS members to use. One version lists over 120 additional ICD-10 codes relevant to otolaryngology, and another lists ICD-10 codes by anatomic/disease area. Other things to do include communicating with payers and vendors, improving documentation practices, assessing claims for mapping risks, and testing claims under ICD-10.”
After the steps have been taken to lay the groundwork for the go live, another consideration is what to communicate with patients. The code switch will take some getting used to for healthcare providers across the country, and that carries with it the risk that the physician will lose overall productivity.
“I think the important message for patients about ICD-10 is that more descriptive codes for their illnesses will improve data and ultimately lead to better patient care,” Dr. Denneny said. “Should the transition to ICD-10 impact a practice’s patient flow, an explanation of why there are delays might be appreciated.”
Dr. Waguespack noted that patients may need to be made aware of issues with reimbursements. “In the event there’s a monkey wrench in the reimbursement process, staff might need to take time to investigate where the problem is and, if necessary, engage the patient and allow the system to work out the kinks,” he said. “Which is why, hopefully, this one-year Medicare allowance to report in the family [of codes] without a reimbursement penalty will be really helpful. This is meant to help practices transition into the new system, not defer implementation.”
Ultimately, the switch is coming without further delay, and the changeover has the potential to cause considerable upheaval for day-to-day medical practice. The only way to mitigate that is to be prepared and educated about what using ICD-10 in day-to-day practice means.