Maintain a solid financial footing through the quagmire of ICD-10 implementation

ICD-10: Are you ready?

I have been around the proverbial block of Long Term Care many times over the last 30-plus years. Occasionally. I have seen signs of pending change—sometimes immediate and sometimes off in the distant, protracted future. Rarely in the last 10 years has any change been more dramatic and more protracted than the transition from ICD-9 to ICD-10. And now it’s here, ready or not. 

The New York Times (9/14, A1, Pear, Subscription Publication, 11.82M) reports that the change “is causing waves of anxiety among health care providers, who fear that claims will be denied and payments delayed if they do not use the new codes, or do not use them properly.” While many providers, I anticipate, have prepared themselves for the change, some may be less certain. This may result in delayed or denied claims with disruptions in cash flow.

Is your team ready for ICD-10? There are so many bases to cover, so many details to acknowledge, so many tasks to take on, and so many transitions to tackle. You’ve planned. You’ve trained. You’ve directed. You’ve encouraged. You’ve engaged. But sometimes, it’s the small and basic tasks that can trip you up or elude you, as you make your way around your own potential LTC ICD-10-studded block.

Get a solid footing – check out the basics – one more time

For example, MLN Matters® Number: SE1408 points out that “ICD-10 diagnosis codes have different rules regarding specificity and providers/suppliers are required to submit the most specific diagnosis codes based upon the information that is available at the time.” Here are a few tips from our “ICD-10 Readiness Briefing” to help you round the next billing block on solid ground:
To assure a smooth transition, have a clear picture of your entire claims submission process. Be sure each stakeholder in the process is ready for the transition.

1. Three mission critical steps to confirm ICD-10 readiness. Confirm that:

• Clinicians and biller(s) are trained.
• Your EMR partner has a crosswalk from ICD-9 to ICD-10 codes and has tested its systems.
• Your clearinghouse and key payers have all the new codes in place and have completed their testing successfully.

• Identify problems that lead to claims being rejected
• Provide basic guidance about how to fix a rejected claim
• Edit the claims to ensure appropriate code sources are used, based on date of service and/or discharge date.

3. Your EMR vendor should supply crosswalks to assist in selecting appropriate groups of ICD-10 codes to use.

Are you ready? What steps has your organization taken to ensure that the ICD-9 to ICD-10 transition is as smooth as possible?

Our free two-page “ICD-10 Readiness Briefing” contains more useful information to make sure you are ready.