Is the clash with ICD-10 unavoidable?

October 1, 2015 is the date when healthcare providers must switch from the existing ICD-9 codes to the new and improved ICD-10 code set. The changes seem so extreme that many doctors are still unsure if they’ll be able to adhere to the transition without significant revenue losses.

The change

The existing ICD-9 codes are approximately 17,000 in total, while the updated ICD-10 codes will exceed 155,000 and preparation for these will not only require excess knowledge, but also significant amounts of training and efforts. If your practice is unable to understand, follow and execute these diagnosis-based codes into its workflows in time; you will lose out on a lot of money through Claim Denials and Rejections.

Come October, you will not be allowed to send out claims using ICD-9 codes; you will instead require completely new ones for ICD-10. So how will they differ from the ones in ICD-9? First of all, they will be extremely specific and more comprehensive. That will be in the form of additional sub-codes for each diagnosis and procedure applied. Additionally, the format of ICD-10 codes will differ from their counterparts in ICD-9, and they will have to be learnt all over again.

Workflows at your practice could be disrupted as learning relevant codes from an option base of 155,000 will be no simple task.

What’s important?

On the HealthIT front, your Electronic Health Record (EHR) and Practice Management (PM) solutions will play a big part.  Their vendor’s readiness will be extremely crucial. A foolproof plan for mapping and the actual conversion, options for training, and the availability of software upgrades will be the most important factors.

Now even with a web based EHR and a PM ready for the conversion, there’s still the training of your staff that needs to be handled. Are you looking to hire a ICD-10 team, depute a ICD-10 champion at your practice, or outsource your medical billing? Even then, who will train your nurses, physicians and support staff, and will they be ready before time?

The clash is unavoidable, and preparation is the best way to meet the challenge!