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ICD-10 is Here: Now What?


The big bang of ICD-10 has happened. Practices should focus on getting reimbursement from third-party payers and clearing up any issues.

So hopefully you and your practice survived the “big bang” ICD-10 conversion.  Our practice had a few bumps with it, specifically with the EHR and there were a few glitches that we are still working through.  Overall though, our offices seemed calm and efficient on Oct. 1 and no one was having a terrible time working in the new coding system.

So, what should your practice be focused on now?  Getting your reimbursement from the third-party payers, of course!

First and foremost, you should be making sure that all providers and nurses are completing their notes in a timely fashion.  Our practice was successful in completing all notes prior to Oct. 1, which was a great start. The charges cannot be submitted to insurance without the notes being finished.  As the senior physician owner in my practice, I am monitoring to make sure the notes are finished quickly.  The office manager could also perform this task.

Next, make sure your coders and charge submitters are keeping up.  We have two full-time pediatric coders and they are usually about five days behind our providers in submitting charges.  As long as the notes are finished, they can complete their duties. If they submit “clean” invoices (meaning accurate ICD-10 coding), there is less likelihood that the charges will be rejected.

Finally, check with your billing department.  MGMA suggests that national average should be 28 days in accounts receivable.  If your billers are below that average, make sure to thank them for good work.  If they are beyond that number, you need to have a chat with them to figure out why.

We are all crossing our fingers that the third-party payers are truly ready for ICD-10.  Only time will tell if this is true.  Hopefully you have taken into account the possibility of delayed payments, especially since this is the fourth quarter and there is little time to catch up if the payments are delayed or your charges are rejected for resubmission. We have delayed some capital purchases and have been careful to build up our savings just in case.

If all the above is handled well, your practice should be able to weather this storm of conversion. Wishing everyone best of luck and success with this massive change in medical coding!

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