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The change to the ICD-10 coding system was greeted with dread and sometimes fear. But now that it's live, it's time to see what it can do.
The anticipation is over-if not the stress-and ICD-10 is no longer a specter, but a real everyday issue. With any luck, things will go smoothly and in the not-too-distant future, it will be a matter more of routine that anxiety. If you really play this well, it could even be a great boon.
Bonnie Dominick, billing manager at Associated Family Practice in Philadelphia, admittedly was completely prepared for the change well before the Oct. 1 implementation date, was actually looking forward to ICD-10. "I think it will be easier. When you look at a claim, you'll know you'll know exactly what was wrong [with the patient] without even having to pull the chart,” she said.
You can use this specificity to improve not only the quality of care, but your bottom line as well. Even if you are seeing a lot of returned claims and experiencing a cash-flow squeeze (hopefully you put some funds back to help with this), in the long run, ICD-10 should actually help with profits. More specific descriptions of the patient's problems will "help justify the rendering of costlier services, if applicable," said Elizabeth Woodcock, president of Woodcock and Associates, an Atlanta-based physician practice consulting firm. "The cost of care has mattered little to physicians until now, but programs like the Value Based Payment Modifier will judge physicians based on cost. As the landscape shifts, ICD-10 will help physicians."
Making ICD-10 work for your bottom line, however, means learning the system thoroughly. Simply cross-walking codes and trying to make ICD-10 a more difficult version of ICD-9 won't do the trick. You have to take advantage of the increased specificity to make it clear to payers exactly what services you are providing and why you are providing them. This will require a fluency with the new language of ICD-10 that may take some time to achieve.
Of course, like any language, it will be useful only if speakers on both sides of the communication are speaking fluently. As Ken Bradley, vice president of strategic planning and regulatory compliance at Duluth, Georgia-based medical claims clearinghouse Navicure, pointed out, the amount ICD-10 will improve profits "could well depend on how comfortable payers and providers become with the depth and specificity [of the coding system]. It has to work on both ends-payers as well as providers. With more accurate payments and fewer requests for additional information, profits should improve in the long run. But it will depend on everyone implementing the new language thoroughly."
This may not be what's foremost on your mind right now, but just knowing that you can make ICD-10 work for you in the long run might make any difficulties in the early days worth the pain.