Ask if they will be upgrading the current version of your software or if you need a different program. Will your current computers work?
How our payors are going to implement the changeover is another possible financial impact. With a more specific coding system, will they pay the same amount as before or will they decide to cut payments for less severe cases?
—Rudy Molina, MD
Look closely at the maintenance contracts you have. They may require the vendor to update your systems at their expense. Find out if this also covers training expenses.
Don’t forget to include vendors for other practice management and reporting systems. Programs for financial management, bill tracking, statistical reporting, and even electronic health records will have to be able to talk to one another.
Next, talk to your clearinghouse or billing service. Ask them when they will be ready for testing. Will their programs be able to support both ICD-9 and ICD-10 codes, or will billings before October 1, 2013, have to be handled on a separate system?
Talk to Your Payors
“The third-group providers need to be actively involved with is their payors,” Tennant says. “Stay in touch with your payor’s provider service contact to find out when each of your major plans will begin accepting test claims. Will they be using the ICD-9 to ICD-10 crosswalks from CMS or proprietary versions? Will there be a specific individual or help desk available to work with as problems arise?”
There will be differences in how various sizes of practices address these issues. The practice with one or two physicians will probably see a larger percentage of the practitioner’s time taken up than the bigger operations.
“Much of this is being taken care of at the corporate or regional level,” says Raymond Hong, MD, MBA, chief of rheumatology at the Ohio Permanente Medical Group in Parma. “There are currently clinical representatives included; the people on the front lines will be involved later.”
Choose ICD-10 Consultants Carefully
Although the ICD-10 changeover is a long way off, consultants have already begun to market their services. As with many other gold-rush scenarios, there will be vast differences in the expertise and credentials among those vying for your business. Caveat emptor.
“There are going to be a lot of consultants trying to get rich over this,” says Grider. “Practices are going to have to be very careful when spending their money.”
The ICD-10 page on the Centers for Medicare & Medicaid Services (CMS) website features a countdown clock that shows the time left until Oct. 1, 2015, the date on which compliance with the new code set becomes mandatory. By the time this issue goes to press, the clock will read 90 or fewer days. Time…
Change will affect all facets of a rheumatology practice, from front desk to doctor charting to finances
For the past 30 years, coders have used the International Classification of Diseases, Ninth Revision (ICD-9) to identify and report diseases, signs, and symptoms as well as to measure morbidity and mortality in the United States. In general, coders identify ICD-9 as the heartbeat of reimbursement for medical procedures because this is what drives medical necessity.
ICD-10 will change the coding and billing landscape, and practices should start preparing now