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Plan Now for ICD-10 Changeover

Kurt Ullman  |  Issue: May 2011  |  May 16, 2011

One red flag is an insistence that people have to already be trained in the new ICD-10 codes. The guidelines and codes are now in draft form and won’t be frozen until October 1, 2012. There is no reason to learn codes that may not even be part of the final set.

The AAPC is currently suggesting that code training not be started until about six months before the final deadline. Start much earlier and training is likely to be forgotten by the time it is needed.

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Check closely any claimed certifications or similar credentials. CMS is not testing anyone or issuing certifications for ICD-10 consultants. In general, if someone claims that some group has endorsed their credentials, contact that group to confirm.

If you already have a relationship with a consultant, see if they offer ICD-10 services. If not, can they suggest someone they know and trust? Find out whom your peers recommend.

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When looking for a consultant, ask questions. What is their general background and credentials? What experience have they had with in areas they are claiming expertise? Approach with caution a person who wants to discuss information technology, for example, with no background in computers.

Find out how long the consultant has been working with ICD-10. Ask them what kinds of training they have had on ICD-10 in particular. Always ask about previous clients, and then contact them for references.

Changes Will Be Costly

Although information systems are the 800-pound gorilla in the room, the financial impact weighs in at around 799 pounds. Estimates of the costs of implementing ICD-10 vary widely.

For example, Nachimson Advisors, LLC, estimates it will cost the typical small practice with three doctors and two administrative staff around $83,000 to fully implement ICD-10. For a large practice employing 100 providers and 64 staff members, the price tag could be as much as $2.7 million.

Some of these costs will be easy to quantify and plan for. After consulting with your information management vendors and looking at the maintenance contracts, the practice should have a good idea of how much to budget for new programs, new hardware, and training on that part of the changeover.

TABLE 1: Gout Codes

2011 ICD-9 Acute gout arthropathy:

  • 274.00
  • 274.01

ICD-10 Acute gout:

  • M10. Gout
    • Acute gout
    • Gout attack
    • Gout flare
    • Gout NOS
    • Podagra
  • M10.00 Idiopathic gout, specified site
  • M10.01 Idiopathic gout, shoulder
    • M10.011 idiopathic gout, right shoulder
    • M10.012 idiopathic gout, left shoulder
    • M10.019 idiopathic gout, unspecified shoulder
  • M10.02 Idiopathic gout, elbow
    • M10.021 idiopathic gout, right elbow
    • M10.022 idiopathic gout, left elbow
    • M10.029 idiopathic gout, unspecified elbow
  • M10.03 Idiopathic gout, wrist
    • M10.031 idiopathic gout, right wrist
    • M10.032 idiopathic gout, left wrist
    • M10.039 idiopathic gout, unspecified wrist
  • M10.04 Idiopathic gout, hand
    • M10.041 idiopathic gout, right hand
    • M10.042 idiopathic gout, left hand
    • M10.049 idiopathic gout, unspecified hand
  • M10.05 Idiopathic gout, hip
    • M10.051 idiopathic gout, right hip
    • M10.052 idiopathic gout, left hip
    • M10.059 idiopathic gout, unspecified hip
  • M10.06 Idiopathic gout, knee
    • M10.061 idiopathic gout, right knee
    • M10.062 idiopathic gout, left knee
    • M10.069 idiopathic gout, unspecified knee
  • M10.07 Idiopathic gout, ankle and foot
    • M10.071 idiopathic gout, left ankle and foot
    • M10.072 idiopathic gout, right ankle and foot
    • M10.079 idiopathic gout, unspecified ankle and foot
  • M10.08 Idiopathic gout, vertebrae
  • M10.09 idiopathic gout, multiple sites

Other areas will require further study before a budget can be put in place. Staff competence in the software and hardware is the first step. After that comes the training of appropriate people on the actual codes.

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Filed under:Billing/CodingPractice Support Tagged with:BillingCodingICD-10ICD-9physicianPractice ManagementReimbursement

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