3 Planning Phases to Get You Ready
New ICD-10 coding changes must be implemented by October 1, 2015 for all agencies who provide care in the home, including skilled nursing agencies, private duty and hospice agencies. This leaves healthcare providers, administrators and owners facing preparation times and plans for new-code adaptions before the deadline hits.
It’s amazing how time flies in instances such as this, isn’t it?
Yet planning is key here. The planning phase is one in which helps determine the success of the impending changes. “Plans are nothing; planning is everything.” -Dwight D. Eisenhower
Feel free to use this blog as a resource for this very important change agent, whether as an individual care provider, as an administrator or as an owner. First, let’s take a look at some of the benefits of the new ICD-10 coding requirements and why they are being enlisted. After that, we’ll step you through some useful planning tools for ICD-10 coding conversions.
Why ICD-10?
In 1990, the World Health Organization revised the 10th Edition of the International Classification of Diseases (ICD-10). Healthcare agencies that are covered by HIPAA are mandated to comply with ICD-9- to-ICD-10 coding conversions by October 2015. ICD-10 coding is designed to capture more clinical, patient, therapeutic and diagnostic information than does ICD-9 coding.
In addition, it is anticipated that the new coding system will better facilitate care management processes and methods, assist in quality care and analytic measurement, as well as to improve the ability to better understand risks, the severity of illnesses, and to capture and record more accurate diagnoses.
The transition to ICD-10 coding will also yield a better picture of current medical practices and clinical documentation. Other anticipated advantages include:
- Improved care coordination between different healthcare settings and environments
- Easier compliance with electronic health record (EHR) mandates
- Increased EHR operability and data sharing capabilities
- ICD-10 PCS captures detailed information regarding medical devices and procedures
- More options of data capture within codes such as right or left side, kidney, left leg, right eye, etc.
- Improved public health analytic
- Increased use of automated tools while coding, resulting in faster processes, decreased labor costs, and decreased coding errors
- Reduced claims rejections and adjudication costs
- Increased payment accuracy
Developed to lessen the amounts of medical fraud, ICD-10 coding is also expected to reduce the need for supporting documentation.
Since the updated code provisions will permit –and even mandate – crucial changes in how health plans reimburse for provider services as well as how service coverage is determined, having a definite plan in place for these changes is paramount.
The 3 Planning Phases
Consider the following Planning Phases for better outcomes in the ICD-10 coding transition:
Phase 1:
- Make certain that the agency leadership team understands the extent and implications of the impending ICD-10 conversions.
- Delegate overall responsibility and authority for decision-making and transition management processes.
- Develop an all-encompassing, yet realistic budget for the conversion process.
- Set a definite timeline for staff training and pertinent policy and procedure updates.
- Obtain ICD-10 code books and forms.
- Obtain training for existing agency coder(s), or outsource coding professionals.
Phase 2:
- Identify regularly used ICD-9 codes and define related ICD-10 codes.
- Develop electronic and paper record templates for the ICD-10 code framework.
- Schedule ICD-10 code conversion training for key staff within your home care agency.
- Define ICD-10 coding through the use of claims – billing and submitting – and other functions such as patient referrals, registering new patients, and eligibility criterion.
Phase 3:
- Solidify billing system compliance to HIPAA Version 5010 transaction standards.
- Verify the agency’s billing system’s ability to submit and receive ICD-10 codes.
- Ascertain your EHR records will handle ICD-10 codes for billing purposes.
- Review all OASIS data for entire medical data capture of patient conditions
- Ask your IT vendor to install software products prior to the October deadline so as to test the software, making sure to involve as many staff persons as possible while obtaining their feedback for any improvements.
Visit the resouce page in the near future for specific changes and differences between ICD-9 and ICD-10 coding practices. You won’t want to miss this one – it’s going to be super handy for identifying what codes are in, what codes are out, top coding errors, and other relevant ICD-10 coding information.
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