Adjusting to ICD-10 in 2015
The ICD-10 Compliance Deadline has been set as October 1, 2015 due to a regulation that was published by the Department of Health and Human Services (HHS) on August 4, 2014. What does this mean for physicians and general medical staff members all over the world? This means that they will need to adjust to new sets of codes and classifications if they are to advance in their medical careers. The compliance deadline is mandatory and all medical staffs will need to get familiar with ICD-10.
The introduction to ICD-10 was signed into law on April 1, 2014 as part of the Protecting Access to Medicare Act of 2014. ICD-10 is an abbreviation for the 10th Revision for International Classification of Diseases and there are core ICD skills that physicians need to have in order to function in the hospital. These core skills include having exceptional knowledge of anatomy, physiology, medical terminology, pharmacology and pathophysiology. Physicians must also be knowledgeable of the necessary procedures and the scientific applications relating to biomedical situations and clinical medicine.
There are some useful steps physicians should take that will aid groups such as the Clinical Documentation Improvement Team and all of these steps are practical. One step doctors should take when adjusting to ICD-10 would be to have proper awareness of the new system. Doctors must be able to memorize the new concepts, requirements and codes that will come with ICD-10. There are significant differences when comparing ICD-10 and its predecessor ICD-9. Considering that ICD-10 is the latest revision, there have been significant changes made to the overall format that doctors will have to adapt to.
Various groups and supporters of ICD-10 training provide bold solutions and the signs have been apparent that there is a need to make the transition to the new classification system. There are several new kinds of codes with ICD-10 that will make clinical documentation and general coding much more complex than the current ICD-9 system and doctors are recommended to start memorizing every notable detail of this new system to understand the updated terminology.
Another step physicians should take when preparing for ICD-10 would be to remain knowledgeable of the existing coding practices in clinical documentation. While ICD-10 will be officially implemented on October 1, 2015, medical staff members will, still be required to use ICD-9 until September 30, 2015, meaning that this current period of time would be most beneficial for the staff to compare the differences between ICD-9 and ICD-10. This studying process will help the staff better understand what they need to do when they submit reports going forward.
The President of the American Medical Association Steven. J. Stack had this to say. “The AMA has long considered ICD-10 to be a massive unfunded mandate that comes at a time when physicians are trying to meet several other technology requirements and risk penalties if they fail to do so.”
Another step for physicians to take would be to enhance communications and planning for ICD-10 training. Physicians need to be in the right mindset when they prepare for revisions such as ICD-10 and conducting simulations of applied ICD-10 schedules beforehand would be ideal. Establishing a routine of applying ICD-10 terminology ahead of the time of its actual implementation would give physicians an advantage in preparation. A smooth transition to this new system heavily depends on the initial steps that are taken, such as matching the solutions based on the needs of the organization.
When dealing with an important transition such as this, communication becomes more important than ever. Talking to practice management or a software vendor would help physicians since they need to know when software updates will be completed for the newly installed system. Talking to clearinghouses, billing service and payers would also help physicians because it needs to be determined when these parties complete their ICD-10 upgrades so that physicians can test with them. Healthcare clearinghouses and payers are also HIPAA covered entities, so they are also required to adjust to the ICD-10 system. Internal testing and external testing with payers is vital for physicians because transactions that carry ICD-10 codes are sent to and received by the payers.
Physicians should also identify the changes they need to make to resources such as coding diagnostic tools, public health reporting tools, “super bills” and the like. It is important for physicians prioritize coders and specialists that are capable of training the rest of the team when they finish the training program. Without the proper training to go around, medical teams may fall behind schedule, which could lead to significant problems as they approach the October 1, 2015 deadline. With proper training, medical staff members will be able to adjust and collaborate more fluently to develop flexible operations in the hospital.
The notable differences between the codes used in ICD-10 and the codes used in ICD-9 include added digits. ICD-10-CM codes are designated for use in documentation diagnoses. These codes are 3 to 7 characters in length and 68,000 in total, whereas with ICD-9 there are only 3 to 5 characters in codes that total up to 14,000. ICD-10-PCS are designated as procedure codes and are alphanumeric, having codes that are 7 characters long that amount to 87,000 codes. Procedure codes in ICD-9 would only have 3 to 4 characters and only amounted to 4,000 codes.
Physicians also need to know what kinds of testing are actually conducted for ICD-10. There are two procedures. One is called Acknowledge Testing where it will be determined whether or not ICD-10 coded claims will make it through Medicare’s claims processing front door. The other is called End To End Testing where claims from submission go through to the receipt of remittance advice. These tests will contain thorough-detailed information. In general terms, these procedures will affect how claims will process and be paid by Medicare with the ICD-10 codes.
One practical thing to summarize from the emergence of ICD-10 would be for physicians to focus on what really matters. The most complex and intricate parts of this new system need to be memorized and figured out first and foremost and the less important factors need to be put aside for the time being. At some point before October 1, 2015 all medical staff members should be able to get in the proper amounts of training and education on this new system because if they get familiar with how the new system works, they will be able to move along and perform their jobs at the hospital as they normally would.