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ICD-10 is now the official language of insurance claims. Here's how to avoid translation problems and other tips to keep your head above water
How well things go for you in the next few months will depend in large measure on how well prepared for today. But even if you did a lot of testing and things went fine, you can still expect some issues, explained Ken Bradley, vice president of strategic planning and regulatory compliance at Duluth, Ga.-based medical claims clearinghouse, Navicure. "Strange things can happen when adjudicating claims in the real environment," he said.
Perhaps the most important thing to do is to take a few breaths, slow down, and make sure every step is accurate before going on to the next step. "Things may take longer, but slowing down and making sure the coding is accurate and everything is just right will save you time and money in the long run," Bradley said.
Nonetheless, things could still get rocky in the next few weeks. Billing expert, Tammie Olson, of Management Resource Group, a firm offering financial management and support services for the healthcare community, gave
a few specific tips and suggestions to help keep your head above water in the coming weeks. Here is the practical-and often reassuring-advice she had to offer:
* Stay up to date with all announcements from your payers. Commercial insurers, Medicare, Medicaid, and Workers Compensation-all will send updates on any issues they are experiencing with ICD-10. Remember, this is new to them, too. They will also have issues.
* Review all claims before submitting to make sure you have the right codes for the date of service. Any dates of service (DOS) prior to Oct. 1, 2015 must be coded with ICD-9 codes. Any DOS on or after Oct. 1, 2015 must be ICD-10. Remember that the code selection for resubmissions and correct claims rides on the DOS date not on the date of submission or resubmission.
* Separate your denials for diagnosis coding from the rest of your denials. This will help you keep track of how much lost revenue is actually due to ICD-10 denials.
* Don't just crosswalk your top 50 or top 100 ICD-9 codes. Take the time to learn and get comfortable with the ICD-10 code book. The ICD-10 codes are likely to be updated every few years, just like the ICD-9 codes were, so cross-walked codes that are good now may become obsolete next October.
* A lot of practices submit a week's worth of claims once a week. This isn't a good strategy. If you have issues with ICD-10, they will be easier to work if you submit your claims in smaller batches.
* If you feel that you are not prepared or cannot handle this alone, it's not too late to call in the experts. Third-party billing/coding companies have beefed up their staffs with experts just for ICD-10.
And even if it does seem a little overwhelming now, rest assured, it will get easier. Olson, who has been working with ICD-10 codes for two years now, finds them easy and likes the new system is better. "The best advice," she said, "is to keep calm and code on."