Have insurers established ICD-10 accommodation periods?

ICD-10 is really here. Yes, for real. After three delays and much discussion and deliberation, ICD-10 is near. 

This October ICD-10 will really happen. Here's the deal: 

1. The ICD-10 deadline was first set for October 2011, then for October 2013, then for October 2014. 
2. But, it seems that the fourth time just might be the charm. 
3. Recent proceedings in the House Energy and Commerce Health Subcommittee hearing on ICD-10 featured seven witnesses, with only one of these witnesses opposing the transition to the new code set. 

Is your practice or organization ready for ICD-10? 

It is clear that ICD-10 needs to be taken seriously. Experts are weighing in, and they are noting that ICD-10 should not be underestimated. For example, Health IT policy director for the Medical Group Management Association, Robert Tennant, wrote on ICD10monitor.com that, "Any organization that looks at the past delays for the coding system and doesn't take the upcoming compliance date seriously is putting their revenue at risk." 

So, since it is vital that your organization take ICD-10 seriously, what can you do to ensure readiness? 

Here are some ways to prepare for the implementation of ICD-10:

• Have an impact chart - conduct an impact assessment and obtain information discovered by this; assessment will show the area impacted and what changes to organization processes will need to happen, and will bring to light impact on coding and billing and vendor management 
• Complete Documentation - Make certain that patient documentation is accurate and up-to-date; ensure accurate codes, and most accurate information has been included in patient records. This will facilitate changes tied to ICD-10 and will help make certain no payments are delayed or denied
• Test - Testing and practice can ensure preparedness; providers can practice billing and coding in old systems but can make sure the information is right to assign the most specific ICD-10 codes

Practices need to maintain systems and continue to improve on implementing technological changes. EMR use can be beneficial, but if not used properly or in the most efficient manners, EMR can be a hassle to organizations. It is important to be prepared and to stay updated on CMS news and continue proper billing and coding and patient record documentation. EMRs benefit practices and organizations by maintaining an electronic paper trail of patient visits and medical conditions and history. Using EMRs can be overwhelming and now with ICD-10 it is clear that physicians and their staff are swamped with work. Hiring a medical scribe could be helpful to your organization. If interested in hiring a medical scribe to help with the proper documentation of patient records please feel free to submit an inquiry on scribesolutions.com. 

Information gathered from FierceHealthIT feature on ICD-10 readiness

Interoperability has become a key topic in today's healthcare research and this issue has brought the collaboration between the private and public sector into the spotlight. 

The Office of the National Coordinator for Health IT has increased efforts recently, timing these efforts with the Meaningful Use deadlines approaching organizations nationwide. U.S. Department of Health and Human Services Secretary Sylvia Matthews Burwell announced a new program last week that would be a two-year grant program for $28 million to encourage adoption of health IT and to increase interoperability, thus supporting the use of the health information exchange. HHS and the new program will include 12 new awards; these awards will be cooperative agreements to states, territories or state designated entities to continue work under the same intent as the original State Health Information Exchange Program. 

As quoted in FierceHealthIT, HHS Secretary Burwell spoke about the new program: "This two-year grant program will ask awardees to demonstrate innovative, community-based solutions to advance, standardize, and secure an interoperable movement of health information across organizations, vendors, and geographic boundaries."

She continued to discuss the importance of the new program for interoperability: "It's important to remember the real reason we're doing this work because if we succeed in our efforts around interoperabilty and delivery system reform, it means that a patient who's admitted to a hospital or referred to a specialist will be more likely to get the right tests and medications because her doctors are doing a better job of coordinating with each other." 

As we know in the medical scribe industry, the increasing presence of technology in healthcare operations can increase efficiency. While technology can improve efficiency and help streamline activity in practices and hospitals, this high-tech environment can cause headaches in the process. This HHS program and the Health Information Exchange are keys to improving the quality of care for patients. But, it is key to hire the right people to implement these changes and to help in the adoption of the rapid changes in the way the healthcare industry does business. Medical scribes can be of assistance to busy practices and organizations that are adapting to the new technological changes in healthcare. 

ICD-10 has been in the news...alot. Whether you like it or not, ICD-10 is going to be shaking things up. So, it is better to get on board now, before it is complicated and costly to do so at a later date.

The American Medical Association published a list of the top 10 issues for physicians to watch in 2015, and ICD-10 implementation and meaningful use are part of this list. 

The AMA list examines the large amount of regulatory requirements, and this list explains that these regulatory requirements can take away from what is most important to most physicians...treating the patient. According to the AMA research, in order to advance health IT, many are asking for some relief when it comes to government mandates. While improving efficiency can be a result of switching to electronic medical records (EMR), the heachaches and hassles that many physicians are facing relate to government regulation and lack of time in effectively treating the patient while also switching to EMR. On the AMA list, meaningful use is focused on and the need for improvement is highlighted, according to FierceHealthcareIT.  

Meaningful Use has been criticized as being too broad and its one-size-fits-all nature has been called incomplete. Sustainability of practices is of great concern to physicians today, so these issues and complaints noted in the AMA list need to be addressed in order to allow for the efficency that improved documentation can provide. Medical scribes can assist in the shift to electronic medical records (EMR) and can stay on as continued providers of efficient documentation of patient records. Using a medical scribe can take away the obstacles that many physicians face in treating the patient while also using EMR technology. Healthcare efficiency is an important topic in today's world, and while the technology can be helpful in documenting patient records and staying organized, using the technology can be time consuming without the assistance of scribes. 

According to the article, the AMA has pushed for end-to-end ICD-10 testing, which the Centers for Medicare & Medicaid Services announced would take place from Jan. 26-30, April 26-May 1, and July 20-24. Also, the article notes that many are starting to make the shift to ICD-10, citing figures by CMS, which revealed that acceptance rates during the November ICD-10 acknowledgement testing week improved to 87 percent. 

Recent reports show that ICD-10 may not break the bank as badly as the AMA once predicted, but the new code set still presents a number of challenges to financially vulnerable healthcare organizations. 

ICD-10 and Big Data

Some doctors might find ICD-10 to include too many codes, but these codes and the new advances of ICD-10 are necessary for big data success in the medical field.

According to resident physician William Rusnak as quoted in a FierceHealth IT article, "doctors will never detect the one-in-a-million disease when it matters". 

Change isn't always easy, but it is here to stay. ICD-10 will be beneficial to doctors and in the big picture the shift to ICD-10 can allow for more efficient and precise coding.

The resident physician quoted in the article, Rusnak, went on to explain the big data benefits of ICD-10, emphasizing that with advanced computing power that can accurately record human behavior, ICD-10 can aid in crucial healthcare situations and lead to further efficiency. 

Rusnak states that there needs to be a code for even the rarest condition that a patient may have, and that a code should represent specific details of any procedures performed as well.

Following Rusnak's advice that codes need to represent all conditions and procedures and even the variations of both, doctors can then collect big data in a precise manner. 

This, in turn, will lead to proper and more accurate decisionmaking when reporting on health. 

ICD-10 will help with big data because the coding will lead to clear-cut reporting on health events and outcomes. 

October 1, 2015 is a big date. Things will change. Be prepared!

AthenaHealth recently hosted a webinar on transitioning to ICD-10. According to AthenaHealth, "the new code set, ICD-10, increases the number of reporting codes from about 13,600 to more than 69,000"; so as you can see, there are some complexities to changing from ICD-9 to ICD-10. 

As you can see in the increase in number of reporting codes, there will be an increase in reporting detail with ICD-10. This transition from ICD-9 to ICD-10 could be very costly for your organization, but there are some preventative measures you can take as a precautionary step.

As a precaution, you and your organization need to converse with your vendor and keep up with the vendor as you transition to ICD-10.

In order to avoid unnecessary costs and headaches, you should ask your vendor some important questions. Here are some helpful questions you should ask your vendor to allow for a smoother transition to ICD-10:

1. What is covered by contracts?
2. What are plans and timelines?
3. How will systems work with both ICD-9 and ICD-10?
4. What does implementation process entail?
5. What are costs, if any, for training and support in shift to ICD-10?

Info gathered at AthenaHealth webinar. For more info on AthenaHealth visit their website http://www.athenahealth.com/

Shifting to ICD-10

ICD-10 will be replacing ICD-9 as the medical classification set forth by the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). ICD-10 includes codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.

What Does This Mean?

ICD-10 is a new change, but stay informed about what it means.

Here are some key facts to know about ICD-10 compliance:

• Transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA), and this is explained in depth on cms.gov.

• The ICD-10 change does not affect CPT coding for outpatient procedures and physician services.

• The deadline for ICD-10 compliance is set for October 1, 2015 to replace ICD-9, as established by the Department of Health and Human Services (HHS) on August 4, 2014.

• ICD-9 will continue to be required until September 30, 2015.

                                   Response to the Change and More Info.

In response to the new compliance date, American Medical Association (AMA) president elect Steven J. Stack stated,“While the AMA appreciates that physicians have additional time to comply with ICD-10, we continue to have fundamental concerns about ICD-10 and its implementation, which will not be resolved by the extra time.”

Testing for ICD-10 will take place by Centers for Medicare and Medicaid Services (CMS) during November 2014 and March and June 2015. Further end-to-end testing will also take place on a rolling basis. Moving to ICD-10 is most likely going to affect all physicians.

Due to increased number of codes, change in number of characters per code and increased code specificity, the transition to ICD-10 will require adequate planning and training.

For even more information, see this article on AMA website.