Claims Processing

Free tip sheet series can help ease transition to ICD-10

. 2 MIN READ

Have you started to prepare for the mandated transition to the ICD-10 code set? As the current Oct. 1 deadline approaches the six-month mark, physicians who are working toward making the move can use a series of free ICD-10 tip sheets developed by the AMA.

If you haven’t begun preparations, start by completing an ICD-10 impact assessment and assessing your documentation needs. Keeping detailed, accurate records can help you code correctly and protect your practice in the event of an audit. You will also need to determine your staff training needs and where and when to get training.

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Next, make sure you’re talking to your vendors and payers. Schedule practice management system upgrades and electronic health record updates to be installed prior to the Oct. 1 deadline or risk being unable to submit claims.

Your health insurers, meanwhile, may make changes to their benefit coverage and the payment rate that will be triggered by an ICD-10 code. Some insurers also may decide to change their acceptance of “unspecified” codes. Be sure to ask your insurers about reimbursement changes, processes for “unspecified” codes and other information.

Finally, it’s critical to complete thorough testing, or you can risk surprises and potential cash-flow interruptions come Oct. 1. Use current patient encounters and code them in ICD-10 to determine whether your documentation was sufficient and whether your software was able to initiate the claim. Participate in any testing being offered by your clearinghouse, billing vendor or payers to make sure your claims will flow through their processing channels after the deadline.

Additional resources from the AMA Store can help get your practice ready for ICD-10, including a downloadable data file of the complete ICD-10 code set to use for testing your system and a documentation guide that provides essential training.

ICD-10 will be extremely costly for physicians, so the AMA continues its efforts to stop the code set’s implementation. You can ask your members of Congress to co-sponsor legislation to halt ICD-10, known as the Cutting Costly Codes Act of 2013, by sending an email through the AMA’s Physician Grassroots Network.

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