Practice Makes Perfect | ICD-10

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Waiting for the Deadline Can Pose Numerous Problems

How can Shannon keep on track when ICD-10 transition seems to be a moving target?

I’ll be putting both the ICD-9 codes and the ICD-10 codes on my forms,” the home health equipment supplier said through the phone at Shannon’s ear, “and I’ll be expecting to know your plans for the transition beginning in August.”

“August?!” Shannon was startled back to attention. She had been getting distracted by raised voices in the hallway. The supplier she referred clients to for mobility equipment had been talking about ICD-10 codes, the new insurance codes required as of October 1st. Where was August coming from?

And what was that noise in the hall?

“I have to get started in August,” the voice in her ear explained patiently, “because my major payer is Medicare and Medicaid. I need time for my transition.”

“Well, I need time too–” Shannon began, but her supplier cut her off.

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“It sometimes seems as though all of you think this is going to happen by osmosis,” he said. “I value your referrals and I certainly want to keep working with you, but I work with too many referrers and payers to take a wait and see approach. I’ll be checking back with you in the first week of August to coordinate plans.”

“I think October is the deadline–” Shannon tried again.

“October it is, and it’s not going to change.” The supplier was beginning to sound testy. “I know a lot of people think there’ll be a delay, but the Centers for Medicare and Medicaid Services have said very clearly that they won’t budge. So I have to be ready on October 1, and I can’t wait till October to start getting ready.”

Shannon stammered a response and ended the call. The noise was still coming from the hallway. She took a deep breath and headed out to deal with it.

“I just don’t see why we have to start doing this now,” Tana was saying to the office manager. There were a few other clinicians standing with her and a couple more office staff watching from a few feet away. Occasional curious looks came from patients as they passed.

“What’s the problem?” Shannon asked, trying to sound upbeat.

“I know we have to change our documentation,” said Tana, “but I thought it wasn’t till October.”

“If we wait till October to start,” said Shannon, “we won’t be in the habit by then and we’ll make mistakes. We have to specify which side of the body and give a lot more detail than we’re used to, so that the new billing codes can be chosen correctly. There are so many new codes that it’ll be a lot more complicated than it is now.”

“So, because we have to take extra time and trouble in October, we have to start right away?” Tana scowled. “That doesn’t make sense. We don’t have lots of free time.”

One of the other clinicians nodded. “I can see the benefits of the new system,” he said, “but it’s totally going to slow us down. Why do that before we have to?”

“Yeah,” Tana agreed. “We’re not children. We don’t need to practice.”

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Shannon knew they weren’t children, but she was fairly sure they needed to practice. Especially if she was going to have to be able to work out the details of the transition in August so she could be sure of a steady supply of home health equipment for her patients.

What’s more, she was feeling wary about the Us versus Them attitude that seemed to be developing between the office staff and the clinicians.

“We’re all in this together and we all need to help each other. We all have to make changes and we know how hard that is. Let’s cooperate, okay?”

Tana rolled her eyes and the knot of workers broke up as everyone walked silently away leaving Shannon alone in the hallway.

Great, Shannon thought, now it can be them against me. She headed back to her office. Clearly, the calendar would have to be updated.

How can Shannon keep on track when the ICD-10 transition seems to be a moving target?

Want to know how to prepare your practice for ICD-10 coding?

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19 replies
  1. Reuven Lirov, M.A.
    Reuven Lirov, M.A. says:

    The ‘Moving Target’ is not ICD-10, but the varying levels of preparedness her fellow practitioners and referral sources tend to have. Shannon needs to be better than her colleagues, which means being prepared sooner. Webinars and software need to be a top priority, along with a clear process to achieve this lofty goal.

  2. Swami Nathan
    Swami Nathan says:

    ICD 10 in October 2014 may be still far off, but it is going to need the providers and billers to be prepared for the change.The simplified approach could be to see what are the frequent ICD9 codes being used in the practice and get the look up done and be prepared with the ICD10 equivalent codes for them. Since it does involve changes to the documentation physicians do,it would be in the best interest to start learning and getting prepared as soon as a practice can.

    Practices working with Super bills could even try creating a ICD10 based super bill and have it audited for correctness. This may be more coding specific but it would help work the denials and rejections if we are prepared what codes should be used.Getting the clinical and the billing staffs updated on the updated training tools and making them know how to look up the sites to get help from would also help.(

    It would definitely be advantageous for Shannon to be prepared with the drills of ICD10 before the actual implementation,this way, when the day arrives, the transition would go seamless. She could also check with the software vendor to check on their preparedness on billing and transmitting the ICD10 codes.

  3. Sonia Dhawan
    Sonia Dhawan says:

    Definitely preparedness is the target and the key here. Staying in touch by attending the right Webinars and updated online information on the transition is very important.

  4. Aseer Kailas
    Aseer Kailas says:

    Shannon needs to outline a plan for the upcoming ICD10 transistion.

    1. Education
    2. Identify Tools, needed for the transition
    3. Work with an Expert ( ICD10 Certified Coder )
    4. Software that have impletmented mappings ( both ICD9 / ICD10 )
    5 Indentify a ICD10 lead, who will help her gather necessary information
    6. Religiously track and document progress, and identify the next step to take.

  5. Charles Pritchard
    Charles Pritchard says:

    Payers are counting on practices to react to ICD-10 as Shannon’s is. Not preparing for ICD-10 by way of documentation is a sure fire way of helping the payers keep more of Shannon’s money. It’s time for Shannon and her staff to prepare for the battle!

  6. Heather Miller
    Heather Miller says:

    Shannon needs to begin practicing and helping her staff prepare. Right now the pain of change is time. Come October the pain may also include money when the insurance companies stop paying.

  7. Ravi Mahajan
    Ravi Mahajan says:

    ICD 10 in October 2014, but Providers and billers need to be
    prepared for the changes. The good approach is to see what are the frequent diagnosis
    codes i.e. ICD9 being used in the practice and get the look up done and be
    prepared with the ICD10 equivalent codes for them. Since it does involve
    changes to the documentation physicians do, it would be in the best interest to
    start learning and getting prepared as soon as a practice can through webinars and
    from all the sources which they come to know.

  8. Robin Kortman
    Robin Kortman says:

    Proactively address the changes such as ICD10 enables you to become proficient before you experience unnecessary pain and loss of revenue.

  9. Naomi Perez
    Naomi Perez says:

    Sadly, Shannon now has to catch up and change the negative attitude festering in her office over this. Her belief that she had until October 2014 to start changes, was a misconception. She needed to have “met” her goals of training and implementing by that date. Being unprepared is making this a more painful process then necessary.

  10. Sylvester,PH
    Sylvester,PH says:

    Change can be difficult, but the KEY TO SUCCESS is to accept the Change and not allow stress to fill the office. Shannon can have a procedure in place for the transition like Map out the change process, Discuss specific areas that will affect the current process, Document it , keep it open for people to follow.

  11. Thomas Jorno
    Thomas Jorno says:

    The consensus among the therapists I work closely with is that their profession has been under assault from Medicare for the past two years. If a practice fails to plan ahead, well in advance of the October deadline, many of them will go broke.

    ICD-10, along with all of the other changes that are coming, need to be taken seriously. The life and death of the practice is at stake. Changes need to be made to the office organization, software, and, if necessary, you staff, before these federal changes are applied.

  12. Amy
    Amy says:

    Procrastination is a sure way to be left behind when the changes take place for ICD-10. Shannon needs to be proactive and get ahead of the game to be sure once the deadline arrives she and her staff are ready. By not being prepared in advance, she risks possible audits, payment delays and loss of patients or more. Get the ball rolling NOW, Shannon!

  13. Deepak Panday
    Deepak Panday says:

    It is just like Final exams.
    We have to prepare for the ICD 10 changes well in advance or else failure is on the cards. which can result in non payments and that makes everyone unhappy.

    So Shannon will need to plan and prepare.

  14. Umesh Khandate
    Umesh Khandate says:

    Shannon should plan and practice the ICD10 transition without delay before ending up in issues and loss of cash flow when ICD10 is implemented and should help staff member to be expertise in ICD10 before October 2014.

  15. Jason Barnes
    Jason Barnes says:

    How do you avoid us vs them? That can plague any offer where change is not presented correctly. It is my experience (I know that I am not unique), that change is resisted fiercely by most.

    Her clinicians don’t worry about money or compliance at this point, because the impact of non-payment or non-compliance isn’t real to them. I have seen practices that have used an incentive program or profit sharing deal with change much more successfully.

  16. David
    David says:

    For Tana to say that they don’t need practice is both childish and unprofessional. It’s not as though they have a choice of whether or not to use ICD-10… and failure to do so will lead to all sorts of problems for the practice. So it’s in their best interest to just grin, bear it and get on with it.

  17. Danielle
    Danielle says:

    Shannon has to get the team to understand that ICD-10 is a major transition and in order for them to run smoothly once the change happens they need to practice. The team should already know that practice makes perfect and provide them with incentives for being prepared and not waiting til the last minute.

  18. Wendy Thorington
    Wendy Thorington says:

    ICD-10 is a major change and all staff will need to work together as a team to be sure they are ready ahead of time.

  19. Lawrence LA
    Lawrence LA says:

    ICD-10 is a major change for all Medical Doctors, Billing companies, also for insurance.
    All must have to prepare before October 2014
    So Shannon will need to plan and prepare

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