Health Information Management

Tip: Take advantage of CMS tips for ICD-10 prep

CDI Strategies, November 21, 2012

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Earlier this month, CMS released a quick tip sheet “Communicating with your Payers about ICD-10.” In it, the agency listed several questions facilities can use to connect with various payers to ensure readiness for the transition slated for October 1, 2014. Questions include:

  • Where is your organization in the transition process for the ICD-10 deadline of October 1, 2014?
  • Who will be my primary contact at your organization for the ICD-10 transition?
  • Can we set up regular check-in meetings to keep our progress on track?
  • When will you be ready to accept test transactions from my practice?
  • What will we need to test with you?
  • Do you anticipate any changes in policies or delays in payments to result from the switch to ICD-10?
In addition to this brief, CMS also published a much more intensive 58-page guide of ICD-10 implementation advice for payers. So if you get on the phone with a payer who indicates that they haven’t begun transition planning yet, refer them to this guide. There is also a quick three-page “FAQ”  available for those who still need some help getting on board with ICD-10 basics such “Why is this happening,” and “When should I start to prepare.”
 
 Previous posts included advice on how to prepare for documentation changes. The article, “How to Prepare for Documentation Changes and Improvements with ICD-10,” states what most CDI professionals have come to know about the ICD-10-CM/PCS code set—“it will require an increased granularity and specificity in documentation.” Interestingly, CMS offers several steps to help facilities begin to parse their documentation and data improvement needs. Including:
  • Review systems that use ICD-9 to identify areas in your revenue cycle, reimbursement rates, HIM, electronic medical records, and clinical systems that will eventually use ICD-10. 
  • Evaluate any potential gaps in clinical conditions or work flow processes that could be affected by increased documentation. Then, update and modify your systems and processes prior to transitioning to the new code sets. This will save your organization time by finding incomplete or non-specific data and ensuring that they do not cause a delay with coding and billing when you finalize implementing ICD-10.
  • Evaluate current software systems to determine if existing elements are cost-effective and efficient. If they are not, upgrade, centralize, or replace them before ICD-10 implementation.
  • Identify staff members to train right away. Determine who will most benefit from ICD-10 training and how your facility will roll out training to CDI professionals, providers, and coders. Staff who will be using ICD-10 will need training to become familiar with the increased documentation standards necessary with the new code sets. Training will help staff members become comfortable with both the heightened specificity and increased number of code sets that they will be using frequently.  
  • Test each stage of the new documentation process in a trial setting. Staff members should simulate a typical patient encounter in its entirety to ensure that data is being documented thoroughly and consistently. This will also help identify any areas that still require improvement in the coding process.
To take advantage of the latest information from CMS sign up the ICD-10 email releases by visiting the CMS ICD-10 website.



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