We can trust CMS and EHR vendors but verification would be nice

By Carl Natale
09:44 AM

This ICD-10 implementation thing might not be so bad. There are electronic health record (EHR) systems that promise to assign ICD-10 codes.

What's the problem?

John Lynn writes that there is a difference between an EHR that says it's ready for ICD-10 and one that is ready. The EHRs that figure out ICD-9 codes then suggest ICD-10 codes that could work are going to be problematic.

Which sounds like a really good reason for end-to-end testing. Find out if EHRs and practice management systems (PMS) can create medical claims with the proper ICD-10 codes.

And that's why many people think it's important that  the Centers for Medicare and Medicaid Services (CMS) conduct thorough end-to-end testing with ICD-10 codes. After all, that's why HealthCare.gov failed.

And The Medical Group Management Association (MGMA) makes that case in its letter to Health and Human Services (HHS) Secretary Kathleen Sebelius that urges HHS to mandate end-to-end ICD-10 testing. What's more important is that "end-to-end testing is the only practical method practices will have to accurately predict and respond to Medicare coding edits and fully understand the impact that ICD-10 will have on reimbursement."

Of course CMS has said that it has designed the ICD-10 DRGs to be revenue neutral.

And your EHR is ICD-10 ready.

Creating an ICD-10 Action Plan: Training, Testing, and Ongoing Review

Robert Tennant, senior policy adviser in the government affairs department for the Medical Group Management Association (MGMA), shares tips for ICD-10 implementation:

  • Start training medical coders about six to nine months before the ICD-10 compliance deadline so they don't need retraining.
  • Team up with other medical practices and pool resources to train trainers.
  • Contact clearinghouses and ask:

    • What ICD-10 services will you provide?
    • Is my submission format appropriate?
    • What will be the cost of the service?
    • When can you accept test claims?
    • Are you offering any training opportunities?
  • Contact health plans about assistance and testing.
  • Monitor government sources and health plans for compliance announcements.

(Physicians Practice)

Measure Twice, Cut Once 5 Biggest Lessons in ICD-10 Documentation Success

  1. "Look to the past to understand the future"
  2. "Get down into the detail"
  3. "Prioritize by risk"
  4. "Fix what you can today"
  5. "ICD-10 documentation isn’t a one-and-done activity"


How Prepared Are Hospitals for ICD-10?

Phoenix Health Systems surveyed 101 hospitals of various sizes and found:

  • Most large hospital systems — 600 to more than 2,000 beds — have little doubt that they will be ready by Oct. 1.
  • Although only a third report their ICD-10 plans are more than 50 percent complete.
  • 58 percent of hospitals with 400 to 600 beds have initiated their ICD-10 implementation projects.
  • 36 percent of hospitals with less than 400 beds have not begun an ICD-10 impact assessment.
  • 60 percent of hospitals with less than 100 beds have not begun an ICD-10 impact assessment.

Three takeaways worth mentioning:

  • Many hospitals reported that they did not have ICD-10 compliance budgeted until 2014.
  • No surprise that the largest healthcare providers are the best prepared.
  • This means there is going t be a lot of work being done in 2014. Expect ICD-10 consultants and trainers to be booked.

(Phoenix Health Systems)

How will the Stage 2 Meaningful Use delay affect ICD-10?

  • Russell P. Branzell, President and CEO of CHIME, doesn't think the meaningful use extension will mean much in terms of making the ICD-10 deadline.
  • But extending compliance could help healthcare providers recover productivity after Oct. 1.


Prepare for New CMS 1500 Form to be Implemented Q1 2014

  • Healthcare providers can start using the claims Jan. 6.
  • There is a field to designate whether ICD-10 or ICD-9 codes are used.
  • Other changes maded to accommodate alpha-numeric codes.
  • The conventional wisdom says to order the new forms now before printers are backlogged.

(Hayes Management Consulting)

Healthcare Ambulatory ICD10: Pay Now or Pray Later

This is kind of a dense post explaining the need to prepare for ICD-10 compliance. The takeaway is that it has to be done. (HIMSS Blog)

Channeling Dr. Bob: A Procedure Coding System for the 21st Century

Rhonda Butler has a pretty thorough look at how ICD-10-PCS was developed and how the language is used. (3M Health Information Systems)

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