Taking the fear out of converting to ICD-10


Any mention of the impending ICD-10 deadline on Oct. 1 strikes fear into the hearts of many a clinician. But in the grand scheme of things, after all is said and done, it may not be as painful as expected.

Yes, there will be time and expenses related to upgrading electronic health records (EHRs) and practice management software, reprinting superbills and other office collateral, and training staff and clinicians. And, yes, some changes to the staff mindset are required. But clinicians who have good documentation now will continue to have good documentation after implementing ICD-10. And with the right tools, the transition to ICD-10 may not be as difficult as many expect it to be.

The first thing practices need to do is to make sure their vendors will be ready. ICD-10 has been coming for a long time, and most billing and EHR vendors will be ready (if they are not already) for practices to assign codes and submit claims. The same can be said for the payers. The questions to ask payers are whether they will pay based on the ICD-9 equivalent diagnosis or on ICD-10 directly, if they will be able to accept either ICD-9 or ICD-10 depending on the date of service provided, and if any of their rules or payment timelines will change. Find out when they will be ready to test.

Next, physicians and office managers should do an internal practice assessment and plan for what needs to be done. Practices need to buy new code books every year, so buy an ICD-10 book and start exploring it. Look at clinical documentation and make sure it is accurate and detailed enough for the new specificity required by ICD-10. Periodic billing audits are always helpful to identify deficient coding and billing practices, but they are also important for clinical care. Could a covering clinician provide good follow-up care based on existing notes? If the answer is no, perhaps some documentation training would benefit the practice, for patient care as well as for billing.

Knowing that practices, especially small practices, need help, ACP has put together a host of resources to help them understand and implement ICD-10. Many of these resources are free, including an interactive implementation guide developed by the Centers for Medicare and Medicaid Services. ACP staff have reviewed, vetted, and negotiated member discounts on several resources to help meet various practice needs and learning styles.

One option is a series of videos created by physicians for physicians that explain the documentation requirements and how they differ from the ICD-9 documentation requirements, particularly for reimbursement. Another project management system helps the implementation team tackle the transition from start to finish, including assessing vendors and payers, mapping, and training. This resource is like a virtual consultant that includes tools, checklists, and code conversion software.

An interactive online training program offers 3- to 5-minute condition-specific modules that include codes, case studies, documentation tips, and quizzes. This resource is designed for use by busy clinicians who prefer to learn as they go.

There is also a digital, downloadable, searchable book that allows users to view ICD-9 and ICD-10 codes side by side. This will help with mapping most frequently used diagnoses from ICD-9 to ICD-10 and could also be used on the fly in the exam room to code the diagnosis. It's like having both books, but downloaded to your laptop.

Many commercial entities are taking advantage of ICD-10, which is why ACP staff put together a variety of affordable resources to meet a variety of needs for its members. Some of these resources provide CME credits, and all are available to ACP members at a discount. To see more information, go online.