Even if October 1, 2014, still seems a long way off, the time to prepare your practice to transition to ICD-10 coding is now--especially when it comes to training, which will entail significant time, expense and effort. Failure to do so, however, could cost your practice more in the long run due to denied claims and inaccurate payments.
Plan on spending about $2,400 on staff education and training costs, advised Maxine Lewis, president of Medical Coding & Reimbursement in Cincinnati, Ohio, in a recent column for Medical Economics. And don't skimp on time. The Medical Group Management Association recommends that medical practices plan for 16 to 24 hours of training for the clinical staff and 40 to 60 hours for coding staff, Lewis noted.
While coders and billers will require the most extensive training, it's critical that everyone from your appointment scheduler to your midlevel providers to physicians understand the importance of specific documentation, medical necessity and guidelines of third-party payers under the new system, she wrote.
For example, the coding process begins when employees tasked with pre-appointment responsibilities, such as obtaining prior authorization, select the right ICD-10 diagnosis code to submit to the insurance company for prior authorization of services, Nancy Enos, an independent consultant with the Medical Group Management Association, recently told FiercePracticeManagement for an eBook about ICD-10 implementation.
"So the receptionist or managed care referral coordinator needs to be trained," she said. "The medical assistant who brings the patient back is going to need to be trained in order to document a good history for the detail that's required for ICD-10 coding," adding that physicians must learn to write more thorough notes.
"When you follow the path of a patient visit from beginning to end, there are a lot of touch points that will have to use diagnosis coding," Enos said.
Medical Economics' Lewis agreed, adding that coders and billers won't just need to learn the new coding system, but also have a strong understanding of medical necessity, which is a major determinant of payment for services. These personnel may also be responsible for handling appeals, she added. "It's going to be interesting to see how many claims are submitted accurately in the first 6 months after implementation," she wrote.
Finally, to help your practice prepare for the financial impact of mistakes and glitches on the practice or payer end, begin building a cash reserve now to cover potential delays in reimbursement.
To learn more:
- read the article from Medical Economics