3 Predictions For The ICD-10 Transition In 2015 (Part II)

Posted by KUNAL JAIN on Nov 25 2014

Fotolia_71637217_Subscription_Monthly_MIn our last blog post, we covered the basics of ICD-10 and its vital components. In this article, we will tackle the subject of how ICD-10 will affect your practice and how PracticeForces can help you transition to ICD-10 with remarkable ease. Three Predictions for the ICD-10 Transition include: 

1. Staff Training Is Crucial To Your ICD-10 Transition (Unless You Outsource Your Medical Billing To PracticeForces)

A sweeping upgrade in your medical billing functions, ICD-10 is light-years ahead of ICD-9 in terms of the level of specificity and detail, as well as the sheer number of codes (which come out to about 140,000 compared to ICD-9’s 18,000 codes). Undergoing the rigorous training on how to incorporate ICD-10 into your healthcare specialization and private practice is a daunting endeavor -- to say the very least. Who has the time and patience to memorize and familiarize even half of what ICD-10 has to offer? It would be like tackling the Encyclopedia Britannica!

PracticeForces has fully-trained and -equipped coding specialists who are well-versed in ICD-10 and its pivotal role in your revenue cycle. By outsourcing your medical billing to PracticeForces, you can make your ICD-10 transition incredibly simple and easy. We will take care of the ICD-10 codes for you, so you won’t have to worry about the potential quandaries, mistakes, and loss of thousands of dollars stemming from the learning curve you would take upon yourself.

2. Make Sure Your Clinical Documentation Falls In Line With ICD-10

The doctor’s clinical documentation has to be compatible with ICD-10’s architecture and superior level of specificity. According to Dr. Joseph C. Nichols Jr., orthopedic surgeon and physician health technology expert, some doctors fall short on clear and thorough clinical documentation:

“If we look at some of the documentation we have today, it is pretty bad. Now, hopefully, most clinicians are not  documenting like this but it still is happening today, and we are still seeing abbreviations that no one understands, probably including the physician who wrote them. Really, this is not only documentation; ultimately, we cannot take proper care of the patient if we do not have good documentation of the key parameters that are important.”

Dr. Nichols also states that nothing is out-of-the-ordinary about ICD-10’s medical documentation of the patient, which draws from the same theory and practices doctors learn in medical school and residency. A few points to consider in your clinical documentation for compatibility to ICD-10 are as follows:

  1. Type of condition
  2. When did it begin?
  3. What caused it (i.e. congenital, physical agent, infection, etc.)?
  4. Anatomical location and laterality
  5. Severity
  6. Time (Is it acute, chronic, recurring)?
  7. Complications
  8. Manifestations and symptoms
  9. External causes (inflicted self-harm, work-related, etc.)

Dr. Nichols advises primary care physicians and other medical specialists to concentrate on the most frequent diagnoses in your practice. Often a handful of diagnoses comprise the vast majority of a private practice’s bottom line. Go over these past cases and see if they match the level of detail necessary for ICD-10. If not, examine what has to be changed in your clinical documentation to bring it up to speed.

3. ICD-10 provides a far more relevant representation of the patient’s medical state and treatment for  billing purposes

Once the doctor takes necessary measures to verify that the accuracy of his/her clinical documentation is on par with  ICD-10, then medical billing because an easier and more lucrative process for the practice. Why? The high level of detail and specificity in ICD-10 codes is geared to present a more relevant picture of the patient’s condition and medical procedure(s) to insurance companies that reimburse you. There’s no ambiguity to it; you get adequate remittance for the exact medical services that you deliver. On the flip side, if the clinical documentation and subsequent coding isn’t precise and accurate enough, then you put yourself at a great risk for getting the insurance  runaround or even flat-out denials.

At PracticeForces, we employ fully-trained and committed medical billing experts who will take care of your ICD-10 needs. Let us utilize this new development to optimize and maximize your revenue cycle and profit. If you have any further questions about our ICD-10 policies, updates to computer systems, EMR software, IT security, or anything else, contact us at 727-771-1300 now!


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Topics: ICD-10 Transition

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