Worried About ICD-10?

Is ICD-10 Really Going to Happen?

This isn’t the first time that we have all walked up to the plate only to have them call the game for a rain delay.  But this time around it does feel like it is really going to happen.  There is a lot of buzz all around the Internet, blogs, and print media talking about the looming October 2015 implementation deadline.  In the process, this is creating an inordinate amount of unnecessary stress, concern, and uncertainty.

What is ICD-10 and Why Do We Need It?

If you are reading this article, then you already know that ICD-9 is the medical diagnosis coding used in the United States at present.  However, to improve clinical communication, ICD-10 will be implemented this coming October.  The intent is to provide more detailed data regarding symptoms, signs, risk factors, etc.

Another important reason for implementation is that we will be able to better communicate across borders.  PracticeStudio is completely localized in Portuguese and is currently being rolled out in Brazil.  Many of these doctors come back and forth between the U.S. and Brazil which makes it all the more important to “speak the same” coding language.  Brazil, along with most other nations, have been using ICD-10 for years now.  With international travel on the rise, it is important that when a medical record is shared between providers across borders, the medical diagnosis is being relayed in the same coding format.

What Does This Mean for Your Clinic?

Don’t worry, the sky is not falling, but there are some things that you need to verify.  First, ICD-9 has 14,000 diagnosis codes and 4,000 procedure codes while ICD-10 has 68,000 diagnosis codes and 87,000 procedure codes.  You don’t need to know them all, just like you didn’t need to know all of the ICD-9 codes.  Depending on your discipline, the number of codes that you use may only go up between 50 and 200 codes.  With PracticeStudio, there are some tools to help identify these codes as well as save them off as favorites so you don’t have to wade through them all.

Second, your EHR system should already be upgraded from 4010 to 5010 for HIPAA transactions.  4010 does not support ICD-10 while 5010 does.  When running older EHR software, most claims clearinghouses will automatically covert your 4010 records to 5010.  However, with the implementation of ICD-10, this will be phased out since most clearinghouses will not automatically convert ICD-9 to ICD-10 codes since this is a medical diagnosis that must be verified by the providers.  This means that you MUST BE on an EHR that fully supports ICD-10 as well as 5010 transactions.  If you are on PracticeStudio X16, then you have nothing to worry about here!

 So How Do I Get Started?

This really isn’t a difficult process, but does require some organization to ensure that your transition to ICD-10 goes smoothly.  Here are some points that will help you get the ball rolling.

1. Ensure that you are on an EHR system that supports both ICD-10 and 5010 EDI transactions.
2. Identify your current workflow and at which points you are using ICD-9 codes.
3. Begin to identify the ICD-10 codes that you will begin using in place of the ICD-9.  With PracticeStudio, you can use the cross-mapping tools to help identify this and then begin to save off your new ICD-10 codes in your favorite lists.
4. (Important step) Talk with your claims clearinghouse to see if they support test claims for ICD-10.  This can be a huge factor in a successful transition.  With PracticeStudio X16, we have the ability to send test claims (5010) with ICD-10 codes to ensure that you are sending proper codes to avoid payment delays.
5. Determine staff training and procedure changes.  MicroFour has been offering Free Training Fridays for 30 minute training sessions on topics of your choice.  It is a first come first serve sign-up, but if you evaluate your needs now you will have more than enough time to get organized and get some free training to make sure you and your staff are ready.  The training needs should be minimal since this really isn’t a major change in workflow, so these 30 minute session should be perfect.  Additionally, MicroFour has been hosting ICD-10 webinars, and will continue to hold them between now and implementation October 1, 2015.  If you missed one, login to the “My Account” area of the PracticeStudio website and catch up when you can.