What are the most common ICD-10 hiccups and remedies?
Hiccup #1: Falling behind schedule, whether because of budget limitations, miscommunication with vendors, or lack of key staff.
Remedy: Work with your current vendor to develop a comprehensive plan and testing strategy and ask for specific reports that monitor progress. Identify and address future potential problems by evaluating your vendor’s past performance with project deadlines and communication.
Hiccup #2: Staff isn’t adequately trained or has the skills to support ICD-10 in your practice. Remedy: Appoint staff leaders who act as knowledge and training champions and are points of contact for ICD-10 questions and concerns. Ensure that they and other appropriate staff are fully trained on ICD-10 code sets, coding guidelines, and mapping tools such as General Equivalence Mappings (GEMs). Relay to all staff the importance of accurate coding.
Hiccup #3: Patients are complaining about claim payment delays, denials, and referral glitches. Remedy: Be sure that staff knows how to respond to patient concerns and train staff to manage complaints about denied or pending authorizations, claims, and referrals. Implement processes for documenting and tracking patient complaints as well as payer issues related to ICD-10 coded claims. Front-office staff members should be equipped with coding tools so they can correctly identify code matches and learn proper ICD-10 coding faster.
Hiccup #4: Physician reimbursement has slowed down, affecting revenue stream as payers aren’t ready to make the transition.
Remedy: Your practice might want to increase cash reserves or secure increased lines of credit to help when payments are slow. If the same claim is submitted twice, once before Oct. 1, 2013, under ICD-9 coding system, and then after that date with ICD-10, payers may examine claims more carefully to avoid these potential duplicate billings and also make more requests for medical records. Be prepared for this by identifying any ICD-10 codes that your practice may inadvertently double-bill and take steps to prevent this. Monitor claim submittals immediately before and after October 1, 2013 to prevent duplicates.
In only seven months, ICD-10 codes need to be implemented and reported in all transactions for encounters. Meeting this compliance might seem like an impossible task. But ramping up doesn’t have to be a nightmare. Make sure your medical and billing system software is properly upgraded; thoroughly train clinical and administrative staff on the new code sets; streamline your business processes and workflow as needed; and update your vendor interfaces, and you’ll be good to go.
