Is Your Practice Ready For ICD-10 Implementation

Are you ready for ICD-10? Well whether you are or not it's coming and its not being delayed any longer. Come to find out, the rest of the world has been using ICD-10 codes for the past two decades, and not only that but the United States endorsed ICD-10 in 1995 and began using it for monthly reporting in 1999. But, wait you say, yes you have it straight, ICD-10 has been around for a long time but we have just been behind the power curve. Now under the new health care reform it is mandatory for medical providers to utilize ICD-10 and they must be in compliance by October 1, 2014. 

Providers will be still treating the same patients and conditions just using different codes. The reason for the switch from ICD-9 to ICD-10 is that ICD-10 captures more information relevant to the condition and diagnosis so that the treatment is more specific. Here is a table so you can see a side by side comparison of ICD-9 and ICD-10 and the differences between them. 

ICD-9-CM Diagnosis Codes                        vs.                    ICD-10-CM Diagnosis Codes
3 to 5 Digits	7 digits
Alpha E and V on 1st character	Alpha or numeric for any character
No place holder characters	Include place holder characters
Terminology	Similar
Index & Tabular Structure	Similar
Coding Guidelines	Somewhat similar
Approximately 14,000 codes	Approximately 69,000 codes
Severity parameters limited	Extensive severity parameters
Does not include laterally	Common definition of laterally
Combination codes limited	Combination codes common

As you can see from the table above their are some differences and similarities between ICD-9 and ICD-10.

Now let's talk about the advantages of ICD-10. The Centers for Medicare & Medicaid Services has given us nine and here they are:

•  Measuring the quality, safety and efficacy of care
•  Designing payment systems and processing claims for reimbursement
•  Conducting research, epidemiological studies, and clinical trials
•  Setting health policy
•  Operational and strategic planning and designing health care delivery systems
•  Monitoring resource utilization
•  Improving clinical, financial, and administrative performance
•  Preventing and detecting health care fraud and abuse
•  Tracking public concerns and assessing risks of adverse public health events

That's just nine. There are plenty more and more shall be reveled once the new code set takes its course and the medical providers are receiving the payments they deserve. 

Lets talk about the implementation process of ICD-I0 and the three main professional roles:

The role of the clinician is to document as accurately as possible the nature of the patient conditions and services done to maintain or improve those conditions.

The role of the coding professional is to assure that coding is consistent with the documentation.

The role of the business manager is to assure that all billing is accurately coded and supported by the documented facts. 

When each of these professionals to do their job correctly the practice is able to stand-up to an audit because the documentation  supports the coding.

So I ask again is your provider, coder, and manager ready for ICD-10 implementation?

My suggestions are to come up with an implementation plan that outlines the duties of everyone involved, define the purpose, plan appropriately, create deadlines, assess your risk, and most importantly make sure your EMR system and practice management system can withstand after this implementation.

Is your EMR and practice management system ready for ICD-10? If, so how much will it cost?

EMRx and iClaim is ready for ICD-10 and there is no upgrade fees!!

Let the Evolving Efficient Experts in Healthcare give you a real time solution for the real time problem you are facing. Contact us today so you can see how our solutions are bridging the gap in the healthcare industry.

Phone: (888) 338-7293  Fax: (888) 391-2109

Email: info@tripleemedicalsolutions.com

Website: www.tripleemedicalsolutions.com

Facebook: Triple E Medical Solutions LLC

References:

DEPARTMENT OF HEALTH AND HUMAN SERVICES , Centers for Medicare & Medicaid Services. (2011). Icd-10-cm classification enhancements. Retrieved from website: http://www.cms.gov/Medicare/Coding/ICD10/downloads/ICD-10QuickRefer.pdf

4 Practice Management Steps to Increase Your Revenue Cycle

There is nothing more annoying than someone telling me the blatantly obvious things I already know. Yet sometimes the obvious things are the things that we often overlook the most frequently. So, if you were to look at any good sports organization or coaching strategy they focus on maintaining and drilling the fundamentals of the sport to ensure that all of the players are up to speed and that they never forget where their base lies. This basic principal can be applied to other avenues of life and business the same way. By focusing on the basics you ensure that all of the other objectives that need to be met are already reinforced by a solid base, thus ensuring that all players at each level are able to perform and execute his/her responsibilities seamlessly and without hesitation to achieve the desired result or to make a play.

After reading the above passage you are probably wondering what does that have to do with my medical practice right? Well I'll tell you and explain the direct correlation to the passage above. With any business, and as we know a medical practice at the end of the day is a business after all, you have a base, and standard that you started with and want to continue to build upon.  Granted you are not coaching a sports team but you are leading patients and your staff. The correlation to a sports team and your practice is simply this, you are trying to orchestrate the performance of the individuals that collectively make up your staff and you want them to achieve a common goal that will ultimately lead you to success.

Establishing Goals

With anything in life we have to set goals and benchmarks that we wish to achieve our ultimate goal of success. So I would like to pose a question to you, what are the goals of your medical practice?
When faced with the above question, often providers will respond with "well that's obvious" or "isn't that pretty evident what we want to achieve". But when asked to clarify or specify verbalize the actual goals they have for their practice they have trouble clearly stating those goals. The question I have is why? It should be obvious, but its truly not. Which takes us back to the fundamentals of running a successful team, organization, or medical practice. So it is safe to say that when starting out one must clearly specify their goals and objectives also known as a "mission statement" and it should take a considerable amount of effort to layout the mission of your business. Now lets discuss how you as the provider can build from the bottom up and improve your revenue in your practice by using some simple steps.

1st Step to Increasing Your Revenue

Write a clear concise statement that outlines the goals and objectives that your practice is trying to achieve. 


2nd Step to Increasing Your Revenue

Be sure to effectively communicate the goals you have set forth for your medical practice.  Work closely with your employees to ensure that they are developing sub-objectives to the primary objectives that will most effectively support the goals you have for the practice. You should be reviewing the sub-objectives to ascertain that they are truly supportive of your goals for your practice.


3rd Step to Increasing Your Revenue

Keep a close eye and monitor the gap in performance, understanding and training. It is virtually essential that an ongoing program be implemented to monitor the performance of the staff members to ensure that all of the goals and objectives are fully understood and that they are all putting their best foot forward to attain success and patient satisfaction. It is imperative that an evaluation system be established to show growth in performance, this ensures that all of the staff is actively working toward the goals established in the "mission statement". Such management review might indicate that additional staff training may be required to effectively meet their sub objectives.


4th Step to Increasing Your Revenue

Periodically update the goals and objectives as they may be required by changing circumstances. Some examples of changing circumstances are implementation of a new EMR/EHR system, or practice management system, transitioning from ICD-9 to ICD-10 coding, and conforming to new HIPAA and HITECH guidelines under the new health reform. It is imperative that management is effective and demands that the objectives and sub-objectives of your practice are updated to reflect the changes and keep the staff in line with the mission and vision of the practice.


Here at Triple E Medical Solutions LLC we offer the solutions that are needed to get your practice on track to increasing your revenue and developing a lasting brand that will give you the comfort you deserve. Let the Evolving Efficient Experts in Healthcare give you real time solutions to the real time problems you are experiencing. You will be given the time to focus more on patients and not on paperwork. Let Triple E Medical Solutions handle your business.

For more information on Triple E Medical Solutions LLC
visit www.tripleemedicalsolutions.com or email us at info@tripleemedicalsolutions.com