Set the groundwork for a successful transition to ICD-10!
I loved the interactive coding practice with the electronic coder and books…very informative and knowledgeable.
Attendee, LeadingAge Affiliates ICD-10 Training, Oklahoma
Now that we have extra time to prepare for the transition to ICD-10 we should make the most of the delay and make sure our transition plans are complete, accurate, and seamless for a successful transition. Years ago we were not reimbursed based on medical coding so we didn’t feel the need to provide formalized training to our staff members. Today all the rules are changing and if we fail to code properly it will negatively affect our bottom line.
As with any new regulations or changes in our industry there are many touch points to consider. Once ICD-10 is implemented we will send our first claims on or about October 31, 2015, in for payment. If that claim is delayed or rejected we will need to investigate the cause. The questions we will need to ask ourselves are:
- Did we code the record correctly?
- Did we enter the codes correctly into our software?
- Did the software assign the codes according to how we chose them?
- Did the codes auto-populate correctly into the billing forms?
- Did the closing process occur without errors?
- Did the claim flow through the clearinghouse system without problems?
- Did the payer accept the claim?
- Was the claim paid?
- Was the claim paid at the correct reimbursement level?
All of the above questions should be considered when implementing a transition plan for an organization. If at least 50% of these questions are dealt with ahead of time before implementing ICD-10 it will take less time to investigate errors, delays, and rejections.
If our staff members are properly trained in ICD-10 we will have confidence that our coding is accurate. If there is a glitch and we are comfortable with coding we can rule out coding errors and work toward solving software or hardware issues. It should take less time to find the problem with the claim and a solution so the accounts receivable does not get out of hand.
What is Your Organization’s ICD-10 IQ?
October 31, 2015 will mark the beginning of a new set of challenges facing healthcare leaders including: new CMS initiatives, intense OIG enforcement activities, increased provider audits and enhanced review and utilization of provider data. One challenge that may pose implications impacting numerous aspects of your organization is the transition to ICD-10, effective October 1, 2015. This transition will not only affect an organization’s reimbursement, compliance, quality, revenue stream, billing, and data
outcomes, it will also affect billing practices, and organizational data critical to success. The implementation of ICD-10 cannot be completed quickly and requires an organized and detailed transition plan.
Test your ICD-10 IQ
Assessing your organization’s ICD-10 IQ is a leader’s critical first step towards creating a roadmap for success. Planning and implementing ICD-10-CM needs to include communication and significant collaboration on information technology, finance, education, and problem solving. The work necessary to implement ICD-10-CM and the resources required truly depends on the readiness of your organization and team’s knowledge.
1) Which code set will we use in long term care, home health, and hospice? ICD-10-CM or ICD-10-PCS. Answer: (Answer, PCS is procedure coding and will not be used in long term care, home health, or hospice. We will only use ICD-10-CM for post-acute care.)
2) What code set am I required to use as of October 1, 2015? Answer: ICD-10-CM
The Pathway Health ICD-10 Transition Solution
Pathway Health is ready to assist long term care providers across the nation with ICD-10 transition plans that will ensure minimal disruption to cash flow, limited claims denials and prevent decreased productivity of those responsible for coding and the ability to prevent major workflow disruptions. The transition plan, at a minimum, should include the following:
- Organization and Readiness Assessment
- Education/Training Plan
- Coder Succession Plan
- Software Vendor Updates/Training
- Implementation Strategies for Successful Outcomes
Be ICD-10 Ready
Pathway Health’s ICD-10 training program provides the knowledge and skills necessary to accurately assign ICD-10 codes for clinical and billing practices. Our instructors are experts in the long term care industry and many are AHIMA ICD-10 approved trainers. Register today for a webinar or classroom training or contact us to discuss how we can customize ICD-10 training to meet your needs.
- 2-Day Classroom Training
- Virtual Classroom Training – Coming Soon!
- Customized Training at Your Location
- Schedule ICD-9.5 Coding Audits – Remote and Onsite Options
Now Available – ICD-10 Essentials for LTC
Pathway Health will give providers the keys to unlock the secret of ICD-10-CM coding. This two day class will provide long term care providers the knowledge and skill needed to accurately assign ICD-10-CM codes for clinical and billing practices. Long term care providers will be confident with their coding process from admission
1. Comprehend definitions of ICD-10-CM terminology
2. Understand official ICD-10 coding guidelines
3. Distinguish the similarities & differences between ICD-9-CM and ICD-10-CM
4. Demonstrate the ability to assign correct ICD-10-CM codes