ICD-10 Deadline Fast Approaching- Only 28 Months Away?

By Penny Henriksen, Genius Solutions' News Editor

Ok, yes, I can hear you rolling your eyes.  You're thinking, "28 months, are you kidding?  That's 2 years and 2 vacations away...really?" Being out and about over the last year and speaking with many of you I also have actually heard "Yeah, but it's the CMS.  It's going to get bumped."  Let's reason together for a few minutes and reflect on this, shall we?

1. First off, the deadline has already been bumped to the October 2013 deadline.
2. Second, the government has gotten the EHR certification testing, implementation, and payments for the ARRA Stimulus plan up and functioning in that amount of time (yes, it's still got a lot of "provisional" in it, but it wasn't delayed and it is working).
3. Third, to have the kinds of things reported that they will actually want to have EHRs keep track of they need more specific information and more precise coding, i.e. they want and need IC-10 coding.
4. Forth, 5010 billing has been in the process of testing and will be implemented in January 2012.  The 5010 form is designed for IC-10 code reporting and was a necessary pre-step in the process.

Basically, my honest opinion is that this is going through.  It is going to be an office reality in 28 short months.

So, what does this mean to you and how can you use these 28 months efficiently?

Now:

1. Start getting familiar with the ICD-10 coding format and what you will need to know and report for your office.  Use the CMS GEMS program to help you begin to identify and cross-walk your codes. (If you are a specialty practice that uses a small sub-set of codes, this will be especially helpful).  Stay up-to-date and be in the know by bookmarking the CMS web site for more and continuing information on ICD-10.
2. Start conducting your own office file audit reviews.  You need to see how your current codes are being documented and supported.  Is there enough detail in your records to support your codes and medical necessity findings?  If not, then doctor and staff need to get more on top of things by documenting and checking your documentation better so that it is good to go.  The new codes are much more detailed and specific, so your documentation will need to be also.
3. Begin to upgrade and improve the knowledge and skill level of all your office staff. 

• Doctors need to know what to report and how best to document and communicate this information to staff who have to report it.
• Staff needs to upgrade their medical knowledge and ability to understand what the doctor is trying to say.  You can start small by upgrading the staff's medical terminology every week.
• Staff also needs to expand their coding ability and skills also, to make sure that they can help the doctor translate doctor-speak into insurance paid-speak. I've said it before: The writing is on the wall, you will need to have at least one certified coder in your office to function with ICD-10. Never has this been, or is it going to be more important.  CPCs® are given a number that has to be reported, just like the doctors have NPI numbers. Don't be surprised if that number becomes a requirement with ICD-10 implementation.  (P.S. Doctors, this doesn't mean that you would not benefit from or improve your skill set by becoming a CPC yourself. You already have the medical knowledge that they test on... you just need to know the coding part. Knowing the coding would help you document better and get paid better.) Upgrading your staff's training and abilities won't just cover your butt when you get to ICD-10 or with meaningful use.  It will also help you to get paid better and to get paid what you are truly worth.  All doctors are not equal, but you only show that to your insurance company through your coding.

In the near future:

1. See #3 above about the certified coders
2. With the level of detail desired and required, not to mention the threat of lowered Medicare reimbursement beginning a couple of years after ICD-10 implementation, you really will need to invest in an EHR program and learn to use it efficiently and effectively. They are making it almost impossible to give them all the information they need, without having an EHR. Even if you don't care about trying for the stimulus money, you should still begin planning your EHR implementation.  However, if you have to do it anyway, perhaps receiving some compensation throughout the process would be good business.

One thing you don't have to worry about: 5010 reporting. At Genius we have your back. You will just need to make sure that you are updated appropriately prior to the 2012 implementation and have set up to use the form when the time comes.  Also stay posted for future news, and first Friday of the month phone conferences with our fabulous Mark T., as he keeps you in the loop of 5010 implementation with Genius.

When you look at everything that needs to be, or should be, done, can you know see how very short 28 months really is?

Additional Resources:

• Official CMS IC-10 web page: http://www.cms.gov/icd10/
• Genius continuing education:  Coding Review Boot Camp, coming up in August, September, and October
• AAPC CPC ® Certification and continuing education
• Check out our Genius EHR options that will take your THOMAS program up to that next level. 

You can also call us at 586.781.9080 or 800.645.0955 for more information on seminars, webinars, or adding EHR to your practice management program.

Please feel free to comment about your implementation woes and go's, talk to us about your concerns. You are definitely not the only one out there thinking or wondering about it.  (Your comments will come to me for approval, so that I can make sure we all don’t get spammed.)