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How Your Medical Practice Can Avoid ICD-10 Pitfalls

How Your Medical Practice Can Avoid ICD-10 Pitfalls

Like many who oversee their practice's day-to-day operations, Kafi Miller is strapped for time and has a lot of competing projects.

Still, Piedmont Ear, Nose, Throat's business office manager, who oversees operations for the 51-person, Atlanta-based practice, spends at least five hours per week just researching the new ICD-10 code set.

While the deadline to transition is more than two years away — CMS recently proposed a new Oct. 1, 2014, implementation date — Miller knows the transition will be wrought with challenges for all involved.

So over the next year, one of Miller's top priorities is to make sure her staff, in addition to the technology her practice uses, is ready for the change.

"Right now we're currently trying to learn the ICD-10 codes that will affect our practice," says Miller. "And once we're able to identify those codes, we'll create a 'pick list' for providers in our EHR module templates where they can select the old code but it will pre-populate with the new alphanumeric ICD-10 codes. It's just customizing our templates, learning what we need, and getting ready for the transition."

Like Miller, many other practice managers will face the similar time-consuming task of making sure staff and physicians are up to speed with ICD-10.

But while migrating to the new code set entails hours of learning and embracing change, there are high-tech solutions — and some great low-tech ones, too — that a practice can use to help offset some of the transitional pains.

Big changes ahead

They say you can't teach an old dog new tricks.

But everyone from seasoned coders to freshly minted, post-residency physicians will have to learn many new ones as of October 2014, one year after CMS originally proposed that ICD-10 become reality.

The consequences of not being ICD-10 ready include claims rejections, denials of payment, and challenges in coordinating care with other medical professionals — just to name a few.

But while many practices might be anxious to get ready, CMS' announcement that it will push back ICD-10 to a still-to-be-determined date has slowed momentum.

"The challenge for those who are close to getting their plans in order is that it's actually very hard to implement a project with a moving date when you don't know how to allocate your resources," says Juliet Santos, senior director of business-centered systems for the Healthcare Information and Management Systems Society and a former practice owner. "Sometimes people will think they have more time than they really do to spend on a particular process."

*For more on some of the specific changes related to ICD-10 and the challenges of transitioning, visit http://bit.ly/ICD-10_pitfalls for a Q&A podcast with Santos.

Regardless of its implementation date, the conversion to ICD-10 will represent a huge shift for practices. The new ICD-10 CM (clinical modification) codes and ICD-10 PCS (inpatient procedure) codes will replace the existing ICD-9 numerical codes with more than five times as many alphanumeric codes. And not only does ICD-10 consist of more than 68,000 codes (compared with approximately 13,000 ICD-9 CM codes), but the new codes are longer and more specific.

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