- Staff Education
- Documentation
- IT
- Reimbursement
Training the staff is the core issue for the ICD-10 Implementation
- Identify the Staff for the Training
- Select the Lead from the team for the Trainer Position
- Identify and Document the clinic workflow
- Understand the areas that need to be paid more attention
- Identify the extent of training required for the staff
- Plan for role based training
ICD-10 CM needs 16-20 hours of training and ICD-10 PCS may need 30-40 hours of training for coders.
Training depends upon the knowledge levels of Anatomy and Physiology. If the staff has no knowledge in Medical terminology, training may take 100-120 hours.
The Major impact of ICD-10 is on the Documentation. As the number of codes has been been increased, there is need for the specificity in the documentation for the approiate reimbursement.
- Identify the Method of Current documentation Documentation may be through the EMRs, Transcription, Scribllling etc.
- Pick some random files and review the documentation
- Pick some procedures ( U/S Scan, X ray etc) and analyse the documentation
- Identify the GAPS
- Document the Lack of Specificity issues
- Document the most common ICD codes for the speciality
- Disucss with physician, and explain the specificity of the codes
- Prepare some sample documention guidelines
- Providers need to undergo training on how to document as per the ICD-10 Codes
As such the Upgradation of hardware is not required. Upgrade the Medical Billing Softwares and EMRs.
On January 1, 2012, standards for electronic health care transactions change from Version 4010/4010A1 to Version 5010. These electronic health care transactions include functions like claims, eligibility inquiries, and remittance advices. Unlike the current Version 4010/4010A1, Version 5010 accommodates the ICD-10 codes, and must be in place first before the changeover to ICD-10. The Version 5010 change occurs well before the ICD-10 implementation date to allow adequate Version 5010 testing and implementation time.
If providers do not conduct electronic health transactions using Version 5010 as of January 1, 2012, delays in claim reimbursement may result. If health plans cannot accept Version 5010 transactions from providers, they may experience a large increase in provider customer service inquiries affecting their operations.
Identify the vendors who can support the ICD10 in the following areas
- Version 5010 to submit the claims
- Incorporating ICD10 codes in EMR
- Documention guidelines
ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service, and inpatient claims with dates of discharge on and after October 1, 2013. Otherwise, your claims and other transactions may be rejected, and you will need to resubmit them with the ICD-10 codes. This could result in delays and may impact your
This change does not affect CPT coding for outpatient procedures.
Reimbursement based on the procedure codes, even though the CPT codes are not going to change, the payment depends up on the Medical Necessity, Matching the CPT- ICD-10 codes appropiately.