ICD-10 – HEALTHCARE BEAT

5 Best Practices To Ensure A Smooth, Expedient ICD-10 Transition

The ICD-10 Compliance date is looming and it is imperative that healthcare providers be prepared to make the transition. It affects everything from claims processing, physicians’ workflow, and patients’ access to care. Many organizations may be rallying employees and resources in order to make the switch from the ICD-9 to the ICD-10 coding for medical diagnoses and inpatient hospital procedures before the implementation date of October 1, 2015.

To make matters worse, the transition is not easy, but a major undertaking with nearly 19 times as many procedure codes and almost five times as many diagnosis codes in the ICD-10 than in the ICD-9. While the ICD-10 switch is definitely necessary, as the outdated and clinically inaccurate ICD-9 has not been updated since its installation, in 1979, the ICD-10 stands to enhance the quality of healthcare, improve data for epidemiological research, as well as enable physicians to make better clinical decisions. However, this is dependent on the ability for the healthcare industry to make a smooth and accurate transition to the new International Classification of Diseases, according to Richard Milam, president and CEO of EnableSoft

In order for healthcare providers to successfully meet the ICD-10 deadline, Milam suggest five best practices to ensure an expedient, smooth ICD-10 transition:

Richard Milam, president and CEO of EnableSoft
1. Employ Robotic Process Automation That Does the Work for You

“You” is meant to imply the entire organization because that is how many resources it will take to have the ICD-10 switch completed by the deadline if Robotic Process Automation is not used to update and add the multiple new codes into EMR, NDC, medical billing, and claims processing data systems. Certain softwares may have to upgraded or replaced to support the 68,000 diagnoses codes and nearly 87,000 procedure codes; however, through a series of human-directed scripts, Robotic Process Automation technologies will populate the specific fields in the data systems with the ICD-10 data required. The already costly transition to the new ICD-10 can be mitigated by not having to outsource or hire new employees to enter the new codes manually. Furthermore, the data transition can take place over the course of a few days, not a few months, ensuring healthcare providers will be ready to transition to using the new ICD-10 codes.

2. Test Your Software

Not only should you confirm with your clearinghouses, billing service, and payers that they will be upgraded and compliant with the ICD-10, but when they will be ready for testing to occur. Robust end-to-end testing must occur with your software in order to ensure claims are being accepted properly and processed by insurance contractors, Medicaid, Medicare, and other payment processes are operational. Test internally to ensure transactions can be generated and sent with the ICD-10 codes and test externally to ensure the transactions are successfully received by payment providers and that the payment can be processed correctly. After October 1, any ICD-9 codes used in transactions will not be accepted for services and will be rejected for payment. Failure to test your software properly can result in disruptions in patients’ receiving the treatment they need and receipt of due payments.

3. Educate or It All Falls Down

The updated, enhanced medical coding that is to enhance and improve patient diagnoses, performed procedures, treatment, and billing will not prove capable of these abilities without humans to employ its codes, terminology, and procedures appropriately and correctly. You must educate your staff about the changes to the ICD-10 and perform practices and routines in order to prepare for the change. Have each of your staff participate in educational seminars in order to become informed of the changes and how that will affect their position, the procedures patients are to undergo based on the new diagnosis codes, as well as the improved treatments that patients are to have performed. Assist and inform staff by identifying the 50-100 most commonly used ICD-9-CM diagnosis codes based on specialties and determine the equivalent ICD-10-CM codes, and have this information accessible before and after the implementation of the ICD-10. Having your staff prepared and knowledgeable about the ICD-10 will reduce delays in patient care and procedures, which is the reason for the ICD-10—to deliver improved diagnosis and advanced medical treatments that will enhance patients’ quality of care.

4. Implement an Effective Communication Method and Coordinate Conflict Resolution

While making the data transition and update to the new and diverse medical coding that is in the ICD-10, it is imminent that there may be delays in processes, confusion over coding and form completion, as well as workflow changes. Make sure your employees know who they can contact or call on if they are unsure of what code to report, how to complete a form, or other transitory questions that may arise following the implementation of the ICD-10. Identify leads and supervisors for each workflow and specialty area that will be available for their staff requests and questions, and make sure those individuals are highly educated on the ICD-10 and have the authority to execute a resolution. Additionally, determine how transactions handled just prior to the compliance date will be handled in order to ensure payment processing will occur—and more importantly—patients are covered financially and receive the best treatment. Identify critical areas or procedures that may be challenging to transition to using the ICD-10 and have practical resolutions for those practices ready to be executed if, and when, needed.

5. Obtain the correct medical documentation and update your forms to support the ICD-10.

Patient intake forms, EMR forms, insurance forms, and superbills must be updated to support the ICD-10 codes. In order to have patient medical records completed correctly and treatments performed effectively, in addition to have payments process, healthcare providers, clearinghouses, and payers must update their forms to reflect the codes in the ICD-10. Physician forms must be updated with the new medical terminology and diagnoses and procedural codes, along with superbills. Identify categories of uncommon services and diagnoses and determine units, time, and cost for each category in order for physicians to be able to report in the EMR and on superbills. Determine and have readily available a list of common or most frequently used abbreviations to ensure they are utilized correctly and correspondently with the ICD-10 terminology and codes. Lastly, and this goes without saying, obtain the updated and correct documentation that will stand as educational and reference material in regards to the ICD-10. The American Medical Association publishes the ICD-10 codebook and other supplementary documentation on topics such as anatomy and physiology, mappings, and coding workbooks. Make sure to have these ICD-10 Bibles available, and in all areas, for staff and physicians to reference when needed or desired.

The healthcare industry is about to embark on an intense change in treatment, reporting, and payment processes as the ICD-10 Compliance date approaches. While the ICD-10 is definitely necessary to reflect advances in medicine and detailed diagnoses, the change is extremely disruptive for healthcare providers. By employing efficient technologies and engaging effective strategies, healthcare providers can execute the ICD-10 transition quickly and accurately by the compliance date. READ MORE

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

MEDICAL CODING & BILLERS

A Visual Guide to Medical Coding

Medical

As of October 1, 2015, there will be more than 144,000 codes that may be applied to patient “stories”

Medical coders provide a critical link between health care providers who are busy caring for patients, and patient insurance companies. Ensuring patient care “stories” are passed to insurance providers in ways they will honor.

Citations:

AHDI Shares Some Great Articles on EHR, patients recording their visits, and ICD-10 … see what you think!

Doctors beware: The EHR debacle may get much worse
American Thinker
More and more people are having the disturbing experience of seeing their doctors spend more time pecking at a computer keyboard than examining them. The doctors are entering data into their patients’ electronic health records in compliance with federal rules introduced a few years ago. EHRs drive doctors crazy. Their own experience tells them that electronic recordkeeping interferes with care, by taking time away from patients.

Patients press the ‘record’ button, making doctors squirm
Washington Post
According to author Christie Aschwanden: My dad had a health scare recently, and at a doctor’s appointment to receive some important test results, my mom wanted to record audio of the visit on her smartphone. “If he had gotten some terrible diagnosis, I wanted to be able to share that discussion with you and your sister,” Mom told me later. But when she asked if it was okay to record, the doctor replied, “No. I don’t want you to do that.”

Senator blasts EHR program
Healthcare IT News
Until physicians have EHRs that can talk with one another, the Precision Medicine Initiative introduced by President Barack Obama could be in jeopardy, Sen. Lamar Alexander said. “We’ve got to get these records to a place where the systems can talk to one another — that’s called interoperability — and also where more doctors, particularly the smaller physicians’ offices, want to adopt these systems, can afford the cost and can be confident that their investment will be of value,” Alexander said.

ICD-10 bill surfaces, calls for delay, more study of rollout disruptions

Healthcare Finance News
Text of a bill by Rep. Ted Poe to delay the switch to ICD-10 diagnostic coding surfaced recently, in which it requests further study on the disruption on healthcare providers could face resulting from the replacement of ICD-9. The three-page bill, H.R. 2126, was proposed on April 30 but the text was not posted for over a week. The bill would prohibit the Secretary of Health and Human Services from replacing ICD-9 with ICD-10 on Oct. 1, as is scheduled.

Almost 90 percent of healthcare providers hacked in last 2 years
Slash Gear
Cyber attackers have increasingly turned their attention to healthcare providers, of which nearly 90-percent were hacked over the course of the last two years. The growing number of cyber attacks against the healthcare industry is said to cost $6 billion annually, marking a trend where hackers shift focus from financial institutions and retailers to those with medical records. All in all, these attacks are said to have doubled in the United States over the last half decade.

CMS promotes ICD-10 readiness with more end-to-end testing
RevCycle Intelligence
There are 142 days left until the International Classification of Diseases — ICD-10 — compliance. What’s next? More Medicare end-to-end testing efforts, says The Centers for Medicare & Medicaid Services. CMS has announced via email announcement a final opportunity for a sampling of volunteers to conduct ICD-10 end-to-end testing. From July 20 through July 24, 2015, the sample group will conduct testing with Medicare Administrative Contractors and the Common Electronic Data Interchange contractor.

Could high-tech health record solutions lead to less expensive healthcare?
Government Technology
Imagine if you never had to fill out another patient information form at a doctor’s office again. That’s the promise of a new portable patient health record service developed by Boca Raton-based InfoPeHR. For $35, patients can buy a credit card-sized USB drive that can hold their records — including high-resolution medical images — for a lifetime, said InfoPeHR owner Bernard Brigonnet.

Misuse of EHR systems and medical errors
EHR Intelligence
Does EHR technology reduce the likelihood of medical errors throughout the healthcare continuum? The input from medical professionals answering this question is mixed. There are certain mistakes that were tied directly back to the misuse of EHR or e-prescribing systems. As previously reported, one pharmacist had ordered acetaminophen for the wrong patient because they had two records open at the same time.

EHR alerts increase HPV vaccine rates 10 times over
Health IT Analytics
EHR alerts that help providers remember to start or complete the HPV vaccine for pediatric patients have significantly increased the rate of protection against cervical cancer. Patients between the ages of 9 and 18 were three times more likely to start the vaccine series and 10 times more likely to finish the entire course when EHR alerts were available to their primary care providers, found a study published this month in the Journal of the American Board of Family Medicine.

US House Bill Introduced to Stop ICD-10

Article by Chris Dimick, Editor-in-chief at the Journal of AHIMA. This article was originally published on the Journal of AHIMA website on May 4, 2015 and is republished here with permission.

A bill has been introduced into the US House of Representatives that would stop the implementation of ICD-10-CM/PCS.

The bill, H.R. 2126, would “prohibit the Secretary of Health and Human Services from replacing ICD-9 with ICD-10 in implementing the HIPAA code set.” Introduced by Rep. Ted Poe (R-TX) on April 30, H.R. 2126 has been referred to the Committee on Energy and Commerce and the Committee on Ways and Means.

Rep. Poe is a long-time opponent of the ICD-10 implementation. In 2013 he introduced a nearly identical bill into the House of Representatives on April 24, 2013, H.R. 1701, that also called for prohibiting HHS from replacing ICD-9 with ICD-10. That bill failed to gain traction and was never taken up by the referred House committees, according to Congress.gov.

H.R. 2126 is co-sponsored by Rep. Blake Farenthold (R-TX), Rep. Mike D. Rogers (R-AL), Rep. Mo Brooks (R-AL), Morgan H. Griffith (R-VA), Rep. Tom Price (R-GA), and Rep. David P. Roe (R-TN).

AHIMA and the Coalition for ICD-10 have called on ICD-10 supporters to continue their advocacy efforts and contact their representatives and senators to prevent any future delay of ICD-10.

Posted by Traci Miller on May 7, 2015

ICD-10 is About Specificity and Documentation

MDS understands that document specificity is critical for ICD-10. You do not want to see an interruption with your payors.

AAPC released recent study results showing clinical documentation of more than 20,000 physicians with only 63% of current documentation adequate to support the ICD-10 requirements. Predictions show one of the largest problems following the October 1, 2014 implementation date for ICD-10 will be documentation insufficient to support the specificity requirements.

Posted on: 02-6-2014 by: Tiffany Lantz

By: Diane Taylor, RN-BC, EHR Intelligence

If you think ICD-10 is all about new codes, you are dead wrong. ICD-10 is really about “documentation” ─ we clinicians have learned from day one that, “If it’s not documented, it wasn’t done.” This situation is even truer in the ICD-10 world, where the coder must build the ICD-10 code based on the presenting story of that patient’s visit from admissions to discharge. With all the new code options, you never know what code will be built.

Case in point: The ED physician sees and diagnoses the patient with head and chest contusions and a fractured femur caused by a motor vehicle accident (MVA). The hospital admits the patient. The nurse, who documents the patient history assessment, discovers the patient hit the vehicle in front of her on a busy residential street. The therapist teaching the patient how to crutch walk discovers new information that the patient was driving home after a fight with her in-laws and was texting when the accident occurred. The entire story is now documented fully and ready for coding to add to the claim’s reimbursement.

A “MVA”, “on a residential street,” “texting while driving” and “fighting with in-laws” are all now capable of being coded. Even though 50 percent of the new ICD-10 codes are based on laterality, there are so many new codes that can be used. Documentation matters. Specificity matters.

Real-time documentation is especially important. Care managers will need to know the documentation is present and when the patient status changes from “Observation” to “Inpatient”. They can no longer wait for the end of the shift for clinicians to document. Medical necessity must be present; if not, queries sent to physicians will likely increase. Clinical documentation improvement (CDI) specialists will have to forward clarifications to physicians if information in the clinician’s note does not correspond with what the physician documented. The volume of queries overall is expected to increase substantially. If documentation is not entered in real time, the longer that information remains on the coder’s desk, the longer the time to attain revenue and reimbursement.

Users of electronic medical record systems also need to be able to document laterality as well as perform in-depth documentation for specificity. For example, a coder will need to receive a thorough description of the wound to understand where the insertion of the IV on the body occurred, the reason for the IV order and the medication administered. To be able to describe the location of injury (i.e., is it located left or right side or upper or lower part of the body?), distal or proximal, medial or lateral, and much more will be even more critical for ICD-10 coding.

Physicians working in medical practices or clinics are expected to experience difficulty adjusting to the new ICD-10 code sets. They will be responsible for providing hospitals with information in ICD-10 form to aid their peers. Clinic orders, such as lab and radiology, will need ICD-10 diagnosis so the hospitals can process these orders appropriately. If the coordination of this level of communication doesn’t improve, patient care and treatment can be affected and denials will surely increase.

So are you really ready for ICD-10? Apparently it’s not just a coding project.

Diane Taylor, RN-BC, Delivery Manager, CTG Health Solutions, is a healthcare professional with 30-plus years’ experience with a focus on clinical transformation and change management.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Transcription, Revenue Cycle Management, AzaleaHealth EHR, and REAL-TIME solutions. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.

ICD-10 requires greater specificity of documentation in the health record and an efficient revenue cycle management system.

“For over 22 years MDS has delivered a variety of medical document services, including medical transcription, editing, EHR technologies, and education programs throughout the Midwest. “The merging of advanced technology has created new demands on physicians. We offer REAL-TIME solutions while helping to improve cash flow, margins and efficiency,” says Donella Aubuchon, CEO of MDS.

MDS chose to partner with Azalea Health to offer a full range of healthcare billing services and EHR solutions to its clients. Aubuchon explains, ” This significantly impacts the administrative and financial side of a practice.” Azalea’s cloud-based software suite comes with a quality support team and a fully-integrated billing and claims management module which boasts an increase in billing accuracy and aids practices in earning up to 15% more in reimbursements. In addition to accuracy, Azalea provides a secure portal for users to both record and transmit sensitive data.”

http://www.prweb.com/releases/MDSofKansas/AzaleaHealth/prweb11319500.htm

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Transcription, Revenue Cycle Management, EHR technology, and REAL-TIME solutions. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.

MDS is excited to be a game-changer in the RCM industry!

The time is right! Let us help reduce the stress incurred by claims denials and lost profits. We focus on your practice’s non-medical, business aspects giving you time to focus on practicing medicine. EHR and RCM should work together and that is why we are offering the most competitive billing services in the industry! Cash-flow is the lifeline of your practice and there is no reason to pay upwards of 12% on receivables. This is damaging to your bottom line.

The burden cost of on-site billing can be more than costly; it can be quite straining to the company creating weighted overhead. Because time, money and resources are valuable assets, MDS’ RCM Services provide the right solution. We have certified, expert billing and coding staff to handle all operations of a patient encounter, securely and accurately. Our software dashboard(s) provide a process and visibility in real time, at the point of care.

Our staff and software support team have a combined 20+ years in billing service analysis, RCM, and business operations and review. Our experience in healthcare documentation with state-specific billing rules and regulations set us apart from others in the industry. We KNOW our business.

Medical Documentation (transcription) & ICD-10

So much buzz out there with M-Modal’s crappy news. It is sad to see US jobs lost to off-shore (again). It is very frustrating, as well as devastating, for those affected. Now more than ever, it is important for MTs, the ones who really want to stay in this industry, to educate and re-tool, and just be diverse! Be ready for whatever comes our way. However, we are believers in dictation because we are listening to our physician friends. We hear what they are saying and we are listening to insurance auditors for major companies. Increased documentation is coming; it will be sink or swim for some and many experts believe the only way physicians will survive is to go back to dictating. Take some time and read the articles below. They contain interesting information on why we could see a push-back on dictation. The Affordable Care Act (Obamacare) and ICD-10 are key reasons. Then you have the physicians who are tired of the clerical roles they have had to assume with EHR.

“These new changes will increase the need for skilled medical transcription and medical coding” Read More.

“Whether you are an advocate or a detractor of Obamacare, we do know that it is going to dramatically increase the required amount of documentation. Secondly, we know that the buzzword for ICD-10 (beyond the other buzzword “PAIN”) is “specificity.” Read more.

“Assuming those medical transcription companies that are here today are still on the scene on Oct. 1, 2013, not having been acquired or retired, (and there certainly are fewer and fewer of them!) I believe they will enjoy increased dictation with the changeover from ICD-9 to ICD-10.” Read more.

The Perfect Storm! Opportunities!