MDNews - Cleveland-Akron-Canton

++ + ++ + +++++++++++++++++++++++++ + + +++++++++++++++++++++++++ BUSINESS SECTION PLANNING FOR ICD-10 By Martha S. Bethea, CPA date seems far away, your practice should be in the process of preparing for this change. ICD-10 includes 69,099 diagnosis codes compared to only 14,315 ICD-9 codes. This 5 fold expansion of codes will require more specific diagnosis, supporting documentation and care targeted to the diagnosis. Since diagnosis codes are used in almost every part of a provider’s operations, the impact of the change will reach into business processes and supporting systems. In addition to the ICD-10 change, I on January 1, 2012 standards for elec- tronic health care transactions change from Version 4010/4010A1 to Version 5010. Version 5010 will accommodate ICD-10 and must be in place before you make the changeover. Planning that needs to be done now includes organizing the imple- mentation process and developing a communication plan and time line. A budget for the additional costs including training and new software or updates will be necessary. You will also CD-10, THE REPLACEMENT and expansion of the current ICD-9 diagnosis codes, is mandatory as of October 1, 2013. While that need to consider the changes to your internal processes that will be required to implement ICD-10. Training will be a key part of the transition to ICD-10. Coders and admin- istrative staff will need to understand how to code ICD-10. Physicians and non-physician providers must under- stand not only the coding but also how to document care to support ICD-10. Many billing issues arise due to insuf- ficient documentation, so adequate documentation becomes even more important with more specifi c codes. Health plan contracting may be impacted. The ICD-10 codes provide more specific information on the diagnosis and severity of illness. Plans may adjust payment schedules to pay less for patients whose diagnosis codes are general or not as severe. Plans may also use ICD-10 to limit coverage and treatment and for medi- cal review and auditing. IT systems will have to be modified and updated to handle the new codes and the documentation required by those codes. New software tools may be developed to provide electronic code selection support. The practice should be working with its practice management and E H R vendor(s) to make sure they are developing and testing their software as well as how their software will interface with other systems including clearinghouses. The vendors should routinely provide and update their timeline for Version 5010 and ICD-10 implementation. The practice must also have adequate time to install, train staff and test the updates before ICD-10 is mandatory. This process should not be delayed. Make sure these processes work accurately well before the October 1, 2013 mandatory deadline or you may find yourself with significant delays in cash flow. The financial impact to a practice that does not prepare thoroughly for ICD-10 will go beyond the cost to train and change systems. Lack of thorough preparation may cause long-term dis- ruption in the ability of the practice to bill and collect for services. Medicare has stated there will not be any further delay to the effective date. If you have not all ready started your planning, now is the time. Martha S. Bethea, CPA is the managing director in charge of the Medical Practice Management Group of CBIZ/MHM LLC in Akron, Ohio. n MDNEWS.COM  JULY-AUGUST 2011  MD NEWS Cleveland-Akron-Canton | 47

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