Transition to ICD-10-CM with Special EHR Coding Features

Posted by KUNAL JAIN on Feb 12 2015

Stethoscope_on_LaptopA crucial component of a specialty-specific practice’s transition to ICD-10-CM is getting hands-on experience with the new codes in an active production setting. The ICD-10 deadline is October 1, 2015, so physicians and staff have approximately 8 months to ensure their readiness – which will minimize production and net revenue setbacks after the deadline hits. After healthcare professionals have taken a few (online or traditional) courses, it would be smart to actually start coding medical records in ICD-10 and conducting claims testing. Several EMR/EHR software tools with EHR coding features may assist physicians with this.

Double Coding: Most EHRs have this “double coding” functionality where physicians and medical coders may code a particular patient’s medical record in ICD-9-CM. Upon completion, they entirely recode the same medical record in ICD-10-CM. Double coding allows thorough comparison, familiarization, and practice in ICD-10 for healthcare professionals. However, this process is also extremely redundant and time-intensive.

Dual Coding: Many physicians and health IT professionals use double coding and dual coding interchangeably, but these terms actually have different meanings. Dual coding makes it possible for one to add ICD-9 and ICD-10 codes simultaneously to a medical record. Therefore, the healthcare professional doesn’t need to completely recode a medical chart in ICD-10 after it was already coded in ICD-9. Naturally, a medical dual coding feature is considerably more efficient than double coding functionality. Physicians and their personnel would achieve that same comparison, familiarity, and practice at a much faster rate.

General Equivalency Mapping (GEM) Tools: Although GEMs don’t supplant the necessary ICD-10 books and courses that healthcare providers should use to train, GEMs do offer a great aid and guide for familiarity and experience. GEMs translate ICD-9 and ICD-10 codes bi-directionally. As an individual codes a medical record in ICD-9, they may use this tool to find the matching ICD-10 code – and vice-versa.

A GEM should have all codes so that coding inaccuracies wouldn’t result from absent codes that should be in this software feature. Additionally, GEMs must have every mapping combination from ICD-9 to ICD-10 and vice-versa. Many new ICD-10 codes, concepts, and specifications should be found in GEMs that aren’t available in ICD-9.

Utilization of these EHR software features has many other benefits besides gaining knowledge and experience with ICD-10-CM in the specialty practice. They facilitate the insurance claims testing process with clearinghouses and payers. Claims testing assists healthcare professionals in isolating issues with ICD-10-based claims so practices don’t face a catastrophic “big bang” in their revenue cycle after the ICD-10 deadline. These issues might be clinical documentation that falls short in the necessary precision and specificity for ICD-10, inaccurate codes, EHR malfunctions, and so on.

Additionally, ICD-10’s granularity provides a more precise representation of the patient’s medical condition over ICD-9 codes. Therefore, insurance reimbursements will also be more accurate and reflective of the patient’s medical condition and treatment. Claims testing using double or dual medical coding will give healthcare providers a good idea of changes to reimbursements based on the new codes.

At PracticeForces, we employ medical billing experts who are fully trained in ICD-10-CM/PCS. Physicians may circumvent many of these ICD-10 preparations (and their costs) if they decide to outsource their medical billing to a third-party agency. Click here for more information on how PracticeForces can enhance your revenue cycle in relatively short order.



Topics: Medical Coding, EHR, ICD-10 Transition

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