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8 Steps to a Smooth ICD - 10 Transition

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Information about 8 Steps to a Smooth ICD - 10 Transition
Health & Medicine

Published on February 20, 2014

Author: judy_gordon

Source: slideshare.net

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The change to ICD-10 diagnosis codes is going to rock the world of medicine, and most of us are woefully behind in preparing for this massive change.

Learn how to tackle the change with 8 action items for a smooth transition - start planning NOW!
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8 Steps for a Smooth ICD-10 Transition Ready to get started on ICD-10? Click here and here for ICD-10 background info and see below for Additional Resources – meanwhile, here’s a step-by-step action plan: 1) Talk to your payers: Start calling your payers now, whether insurance companies or Medicaid/Medicare, and find out what codes they will be requiring, especially for your niche (mental health, ABA, substance abuse, IOP, speech therapy, Nutrition, etc). Will they call for any DSM-5? Do they have any special ICD-10 stipulations? Once you know what you need to provide, the pathway is somewhat set for you. 2) Decide which conversion pathway you want to follow: If y0u don’t use DSM, there’s only one way to go: ICD-9 to ICD-10. However, if you want or need to use DSM, it’s a little more complicated. Do you want to convert from DSM-IV to DSM-5 to ICD-10? Are you already using DSM5? Do your payers require both DSM and ICD? Pick your conversion pathway and determine how you will convert your codes: there are multiple options available, from crosswalks & conversion software for purchase, to free conversion tools on the Web. Be sure to confirm the accuracy of whatever conversion tool(s) you choose. 3) Train your staff: after deciding on your best conversion pathway, educate your staff on the predicted changes and how they might affect business. Thoroughly train all staff on the newly implemented pathway and their changing courses of action, and plan on having your staff trained and ready to test by late spring/early summer. Keep in mind that ICD-10 codes are required for dates of services after 10/1/14, but claims processed with a date of service prior to 10/1 should still be coded in ICD-9, regardless of when they are submitted. Additionally, non-HIPAA covered entities such as workman’s compensation are not required to transition to ICD-10. You will need to train your staff on recognizing these distinctions and billing fluidly with both code sets. 4) Schedule testing with your payers for late spring/early summer to leave plenty of time for correcting errors and preparing to go live. You won’t fully understand how much ICD-10 will affect you until you test the new codes with your payers. Your flexible, comprehensive EHR solution! www.pimsyemr.com 8 Easy Steps for ICD-10

5) Test with your practice: the hardest part of this transition will be getting your staff trained to pick the right code and get used to business under this new framework - as you start testing with your payers, test your employees and make sure everything is running smoothly for them. 6) Save and set aside: put away as much money as possible in case payments are delayed during the transition (remember the January 2013 CPT debacle for mental health!?) 7) Create updated revenue plans: if it takes your staff 2-3 times as long to process notes or claims, what changes do you need to make to ensure business viability? 8) Hire an expert: the easiest way to make this challenge as smooth as possible is to secure an ICD-10 expert to conduct a risk assessment of your practice and get you on track for a successful transition. They can determine how much you will be impacted and create an implementation timeline to ensure you are testing the new codes early enough to catch & fix errors and meet the deadline. Because of the complex interactions between DSM-IV & DSM-5 and ICD-9 & 10, it’s a good idea to hire a consultant well-versed in mental & behavioral health. Additional Resources PIMSY ICD-10 Resource Center PIMSY ICD-10 Forum ICD-10 for Behavioral Health blog How do ICD, DSM, and CPT interact for mental health? Transition to ICD-10 AAPC Fast Forward Top 50 Codes Conversion PDF Centers for Medicare and Medicaid Services (CMS) ICD-10 Provider Resources ICD-10 Implementation Guide for Small and Medium Practices Small and Medium Practices ICD-10 Checklist ICD-10 Implementation Guide for Large Practices American College of Physicians ICD-10 Resource Center ICD-10 Conversion Tool and Resources AAPC Coding Books Disclaimer: Ultimately, it is the responsibility of each practice to ensure ICD compliance, including the 10/1/14 ICD-10 transition. PIMSY EMR/SMIS has gathered information from various resources believed to be authorities in their field. However, neither PIMSY EMR/SMIS nor the authors warrant that the information is in every respect accurate and/or complete. PIMSY EMR/SMIS assumes no responsibility for use of the information provided. Neither PIMSY EMR/SMIS nor the authors shall be responsible for, and expressly disclaim liability for, damages of any kind arising out of the use of, reference to, or reliance on, the content of these educational materials. These materials are for informational purposes only. PIMSY EMR/SMIS does not provide medic al, legal, financial or other professional advice and readers are encouraged to consult a professional advisor for such advice. Your flexible, comprehensive EHR solution! www.pimsyemr.com 8 Easy Steps for ICD-10

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