ICD-10, Be Financially Prepared Before October 2014

As a follow-up to my ICD-10 article yesterday, I thought it was definitely worth mentioning this article by Matt Dallmann over at Physicians Practice.

My article focused mainly on the sheer number of codes and how I felt that would affect providers in their daily operations. In his article today, Matt discusses the potential, or actually, the likelihood for a delay in reimbursements as this transition takes place.

As quoted below, he mentions that it will likely cause computer glitches, etc., causing delays and a headache for many providers.

“There are a number of issues you should look out for, ranging from systemic changes to computer glitches. The expansion of diagnosis codes will be an obvious problem. Individual procedure codes are already payable with a limited number of specific ICD-9 diagnosis codes. This will be compounded when a single ICD-9 code translates to a full page of ICD-10 codes. If it isn’t difficult enough to navigate these changes on their own, details will be even more difficult to identify and correct in the context of each third-party payer’s guidelines for ICD-10. Computer glitches will be a problem, and the likelihood of submission delays and rejections is high. After all, hundreds of billing systems, electronic clearinghouses, and commercial and government computer systems must be updated to be cross compatible overnight.

First, and most importantly, you should have a financial reserve to cover overhead costs in the fourth quarter of 2014. Second, you should contact your practice management, billing, and EHR providers to confirm that they are prepared to be ICD-10 compliant by Oct. 1. And third, you should ask about the new coding policies that commercial carriers plan to adopt for your most commonly used codes, and familiarize yourself with the new codes you will be using. Make a list or cheat sheet of the commercial carriers’ new policies for your office to reference when coding, and create flow sheets that expand your most commonly used ICD-9 codes to their ICD-10 counterparts to help with the transition. You may also want to send out small samplings of claims instead of full batches to test for errors or rejections. This will save money on resubmission costs.”

Matt’s advice should not be taken lightly, Have a reserve! It’s almost inevitable that if you do not have a financial reserve on October 1st, you’ll definitely feel the wrath of ICD-10 in your wallet.

Additional Resources: OMG’s ICD-10 Preparedness and Online Resource List

View all Articles by: Melissa Clark, CCS-P