How to Facilitate the Transition to ICD-10 for Medical Billing in Your Office - dummies

How to Facilitate the Transition to ICD-10 for Medical Billing in Your Office

The transition in medical billing to ICD-10 WILL happen and it is essential you understand how to facilitate this in your own office. As you move toward ICD-10, remember that claim transactions are the foundation of the financial stability of every healthcare provider’s practice, be it a physician or non-physician provider. You should still be ready for the transition and not risk the chance of being unable to file claims.

ICD-10 demands a transition plan both for the physician and his or her staff. To put it bluntly: Get ready! Discuss with your employer the training needed for each member of the staff and stress the need for further education, without which you will struggle with choosing the correct codes and helping the physician and clinical staff improve the documentation techniques necessary for correct coding.

To make all of this ICD magic happen, your provider is going to have to update the office billing software (as will the clearinghouse and every payer). Providers should prepare for ICD-10 well before the implementation deadline, which means that you have some prep work to do as well. Here are some steps that can help you and your provider prepare for the big switch:

  1. Prepare a report that lists currently used ICD-9 codes in order of frequency.

    Online tools or cross coding translators that map ICD-9 codes to ICD-10 codes can help with this task. (The AAPC has an ICD-10 code translator, and so does Medicare.) These can assist in identifying the ICD-10 codes that the provider will likely use the most.

  2. After you identify the most frequently used codes, check current documentation and see whether it supports the mapped codes.

    If your office uses a super-bill, you can start with the ICD-9 codes that are listed on the form to identify the matching ICD-10 codes and make sure that current documentation supports the replacement codes. (Note: Everyone on the coding and billing staff should also be prepared to learn these codes and the specific anatomical relationship each represents.)

  3. After you complete this exercise for the most frequently used codes, expand to the other specialized codes that pertain to the office clientele.

    By completing Steps 1–3, you have identified the ICD-10 codes that will soon be part of the daily routine.

  4. Alert the practitioner to the specific documentation that is missing from current patient records.

If the office will continue to use super-bills, this process can help identify which codes should be listed on the form. You can also work with the billing software vendor to make sure that the ICD-10 codes that are likely to be used immediately upon transition are programmed into the software. If not, you can make them aware of your expectations.

Getting your software vendor involved with the switch is just as important as doing the necessary work on your end, so make sure that your software vendor is able to meet the new office needs and is willing to give you all planned updates along with transition dates and deadlines in writing.