• AMA estimates cost for 3-MD practice = $83,290• You can’t budget for your organization until you understand what it will involve: • Conduct an impact assessment • Budget time and resources accordingly
Impact Analysis • What systems / workflows does ICD-9 touch today? • Who needs training? • Coders, billers, physicians • How will EHR adoption impact practice mgmt., billing, coding, reporting, etc.?
• Budgeting may require you to make educated guesses on expenses that cannot be calculated • Ex: Diminished productivity for coders and providers during the transition
• Ask vendors about their ICD-10 prep and anticipated timelines.• Not confident your EHR vendor will smoothly transition your system to ICD-10? • Consider switching to an EHR partner that is committed to ensuring your success.
• BCBS Association estimates coding errors will increase 10-25% in 1st year of transition• Improving clinical documentation is one of the best ways to prepare for the transition’s impact on productivity of physicians and coders.
• More codes means more documentation• Documentation Considerations • Linking relevant conditions • Initial Encounter → 7th Character Extension “A” for Patient under Active Treatment
• Documentation Considerations • Subsequent Encounter → 7th Character Extension “D” for Routine Injury Care during Healing / Recovery • Sequela → 7th Character Extension “S” for Complications / Conditions resulting from an injury (E.g., Scar resulting from a burn)
• Clinical Documentation Assessments • Do random samples support ICD- 10 coding?• Implement Documentation Improvement Strategies • Train → reassess → train again• Appoint an ICD-10 Implementation/ Documentation Champion
• The ICD-10 transition is likely to cause disruptions in cash flow for a number of reasons. • Clean claims may take longer to be submitted due to productivity declines. • Denials may spike due to mapping or coding errors.
• Take steps to protect cash flow during the transition: • Budget for additional cash reserves • Ask major payers about their readiness to process claims coded in ICD-10
• Take steps to protect cash flow during the transition: • Improve clinical documentation to minimize denials • Plan your strategy to manage denials before, during & after ICD-10 implementation