CMS recently offered new tools for the ICD-10 transition. But some providers are still floundering.
Last month, CMS agreed to offer providers a much-needed safety net, by allowing less coding specificity and not denying claims based solely on coding errors for the first year of the transition to the ICD-10 coding system. With that, the agency also announced that it would be offering more training and educational resources. Many of those tools are now available, but how much help are they?
The new tools consist of timelines, checklists, and links to training modules. There is not much new here-beyond explaining the regulations of the new policies during the transition period. Plenty of those resources were already available. "For practices just getting started, it could be helpful," said Ken Bradley vice president of strategic planning and regulatory compliance at Duluth, Georgia-based medical claims clearinghouse, Navicure. Having comprehensive planning tools in one place could help providers be sure they've "dotted the i's and crossed the t's," he said.
At the same time, many practices that have been preparing for months are still struggling. Some aren't finding the material-new or old-much help at all. Joan Ross, practice manager at a large orthopedic practice near Fort Lauderdale, Florida, has found her dealings with CMS less than helpful. "I don't learn anything from CMS, and what they do tell me is confusing," she said. Ross is concerned about a lot of the details, such as how to manage split billing for a patient who goes into the hospital on Sept.30, but has surgery on Oct. 1.
The answers to questions like this are out there, but may be getting lost in the noise. There is so much information available that providers like Ross are having trouble finding what they need. After all, busy physicians and practice managers don't have time to dig around on the CMS website trying to find answers. Ross is depending on her EHR vendor to help her over the bumps.
As far as the break on specificity is concerned, Ross isn't really sure that will be all that helpful either. What she would really like is to have a year of dual coding. "I understand that we need the new codes, and they are definitely a good thing, but I don't think the industry is ready to jump right in," she said. When asked how much of a relief it is knowing that CMS won't deny claims due solely to incorrect coding, Ross said, "I'm not sure it's fair to say I believe that. I have the notion that some claims will be knocked out of the computer because of bad codes. It's just computers talking to computers."
It is clear that CMS is doing everything it can to make this transition go as smoothly as possible. How useful that help really is, and whether it is reaching the people who need it most, is not so clear.