The Centers for Medicare & Medicaid Services (CMS) recently talked with providers to identify common misperceptions about the transition to ICD-10 in order to help dispel some of the myths surrounding ICD-10.  Some of the most common questions and concerns about ICD-10 are covered in these five facts written by CMS.

The Five Facts about ICD-10 & CMS comments about them

1. The ICD-10 transition date is October 1, 2015.

The government, payers, and large providers alike have made a substantial investment in ICD-10.  This cost will rise if the transition is delayed, and further ICD-10 delays will lead to an unnecessary rise in health care costs.  Get ready now for ICD-10.

2. You don’t have to use 68,000 codes.

Your practice does not use all 13,000 diagnosis codes available in ICD-9.  Nor will it be required to use the 68,000 codes that ICD-10 offers.  As you do now, your practice will use a very small subset of the codes.

3. You will use a similar process to look up ICD-10 codes that you use with ICD-9.

Increasing the number of diagnosis codes does not necessarily make ICD-10 harder to use.  As with ICD-9, an alphabetic index and electronic tools are available to help you with code selection.

4. Outpatient and office procedure codes aren’t changing.

The transition to ICD-10 for diagnosis coding and inpatient procedure coding does not affect the use of CPT for outpatient and office coding.  Your practice will continue to use CPT.

5. All Medicare fee-for-service providers have the opportunity to conduct testing with CMS before the ICD-10 transition.

Your practice or clearinghouse can conduct acknowledgement testing at any time with your Medicare Administrative Contractor (MAC).  Testing will ensure you can submit claims with ICD-10 codes.  During a special “acknowledgment testing” week to be held on June 2015, you will have access to real-time help desk support.  Contact your MAC for details about testing plans and opportunities.

What this means for smaller independent practices (from our perspective)

First – if you feel you aren’t prepared, there is no time like today to get started.

What do you need to do to get prepared?  That answer is different for each different practice, but we have some resources available for you.  Use the ones that fit best with where you are at.

ICD-10 Planning Tools

ICD-10 Webinar Series – A few months back we hosted a series of ICD-10 webinars.  You can access the recordings now by clicking here.  In these 4 short webinars (each recording is between 30 to 45 minutes) we provide a lot of information to help with planning, to help you learn how to use the ICD-10 tools that are built into Medisoft v20/v19 and Lytec 2015/2014, how to conduct testing with your clearinghouse, and give other tips on how to become ICD-10 ready.

Quick ICD-10 Planning Checklist – This 1 page (front and back) checklist summarizes in simple terms what you need to consider for your practice to get ICD-10 ready.

ICD-10 Impact Summary – This 1 page (front side only) info sheet summarizes how ICD-10 might impact different aspects of your practice to help you understand what changes you might need to make.

Roadto10.org – They have some videos you can watch, a “Build Your Action Plan” tool you can use and many other articles and other resources.

Second – you need to upgrade to the ICD-10 ready version of your software.

Your software is not ICD-10 ready if you are not on Medisoft v20/v19, or Lytec 2015/2014.  Medisoft v18 or any other earlier model is not ICD-10 ready.  Lytec 2013 or any other earlier model is not ICD-10 ready.

Call us today at (888) 799-4777 to get your ICD-10 ready software.

Third – consider additional software solutions to help make the transition easier.

In addition to upgrading to Medisoft v20 or Lytec 2015, there are additional tools that can help make things easier.  Fact number 3 above provided by CMS states that electronic tools are available to help you with code selection.  Here are the tools that we have to offer.

Codes on Disk

If your time is valuable then you are going to truly appreciate this simple tool.  Import the latest CPT-4, ICD-10, and HCPCS codes for your specialty into Medisoft or Lytec to assist you with implementing the standard code set requirement for HIPAA.  Save yourself hours of manual labor entering all those procedure and diagnosis codes.  This tool can be used by existing Lytec and Medisoft users alike.  It will not erase your existing codes.

Encoder Pro

Encoder pro enables users to simultaneously search across ICD-10, CPT, and HCPCS codes to get integrated search results, code details, and descriptions.  This will save so much time compared to searching a physical code book by hand.  If you have Google or Bing at your fingertips, would you ever go pick up a phone book or encyclopedia or dictionary?  Take advantage of Encoder Pro the way you use Google to find things out.

EMR

Has your practice implemented an EMR yet?  If you are not using EMR yet, let ICD-10 be another reason to consider it.

How can EMR help with ICD-10?  The short answer is that we cover 5 ways an EMR can help make the transition to ICD-10 easier in our webinar series mentioned above.  Feel free to watch the webinar recordings.

Still not really a direct answer, but here are two questions to consider to get you started thinking about it.

Question 1: What is your paper superbill going to look like with the expanded list of codes you will use in your practice?

Question 2: With an increased need for documentation, how are you going to retrain yourself or your staff to be better at documentation?

With the transition to ICD-10, even though you won’t need to use all 68,000 codes, you will definitely see an increase in the number of codes you are using on a regular basis.  This could significantly increase the size of your superbill.  If you are seeing patients with a four or eight page superbill, how fun will that be to manage?

By implementing an EMR, you will make the switch to an electronic superbill which will be so much better for managing all those codes.  Additionally, the documentation needed with your ICD-10 claims will be taken care of for you while using the EMR program.

There are several other ways an EMR can help with ICD-10, which are covered in our webinar replay you can watch.  And of course EMR helps in many other aspects with amazing tools like e-prescribing, lab-interfaces, eliminating paper charts and helping to improve patient care to name just a few.  To learn more about our Medisoft and Lytec EMR options or to schedule a demo, just give us a call!

Lastly – practice using ICD-10 codes starting ASAP!

Practice!  Practice!  Practice!

Even if you have all of the tools that you need, if you wait until October 1 to start using everything, then it will be a rough transition.  If you haven’t worked out your own kinks, then you could see significant delays in getting your claims paid and you will be frustrated with the process.  Don’t do that to yourself.  You can start practicing today!

Here are a couple tips to help you start practicing.

Our second webinar recording shows you how to put your software (either Lytec or Medisoft) into “testing mode” so that you can submit test claims.  In our third webinar, we outline how you can test your ICD-10 claims with your clearinghouse.  We provide specific information from Relay Health because that is our preferred clearinghouse, but we give you the info you need so you can enquire with your own.

There is also a feature in your ICD-10 version of the program that allows you to just start coding everything in ICD-10 right now, but your claims will still be submitted in ICD-9 right up until September 30th!  In the program, you can set a date for when to start submitting your ICD-10 claims.  Set that date right now so you don’t need to worry about making any changes on the morning of October 1.  

Doing all this will allow you to practice coding in ICD-10 now and so that you and your staff can get comfortable with the changes, but without the added stress of potentially delayed payments.

That’s it for now.

If you’ve been working on getting ICD-10 ready at your practice – feel free to share your successes or your failures with the community so we can learn from each other.  Share with us in the comments below!