“How our payors are going to implement the changeover is another possible financial impact,” said Dr. Molina. “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? This is a big unknown from our standpoint.”
Both systems have an “unspecified” code. Will payors accept that or require more information to better use the depth of information new codes make available?
Financial contingency planning is another concern that must be addressed. Because there will be no pilot before changeover, little is known about potential problems. Experts have forecast everything from a smooth changeover to computer-directed Armageddon, and all possible scenarios in between.
“In case there is a meltdown, practices should prepare by banking reserves, establishing lines of credit, and arranging for needed loans in advance,” Tennant says. “While I don’t really expect any major problems, it is better to protect the business continuity of the practice by having these in place in case they are needed.”
The key to a successful change is careful planning that starts immediately. Otherwise, practices risk severe financial consequences, especially under current general and healthcare economic conditions. “The physician’s world is being turned upside down with healthcare reform, the Medicare/Medicaid affordability act, and mandates for electronic medical records, among others,” says Chung. “If practices are not very careful, they will find themselves overwhelmed with the transition to ICD-10, which could cause major disruptions in cash flow. Preparation is the key to success for the next generation of coding. ”
Kurt Ullman is a freelance writer based in Indiana.
For More Information
American College of Rheumatology:
- Currently includes information for practice management. This will also be the main area for information on webinars and seminars at the annual meeting between now and final implementation.
Healthcare Information and Management Systems Society:
- This website includes links to Excel spreadsheets for cost prediction models, vendor assessment worksheets, and various presentations on topics such as establishing time lines, contracting, training principles, and detailed questions an organization should consider as they begin work toward implementing 5010 and ICD-10 regulations.
- Includes links to information on the impacts of ICD-10 with an emphasis on coding. In addition to frequently asked questions, there are links to training sponsored by the organization and discussion groups for coders.
Centers for Medicare and Medicaid Services:
- This site has information on how ICD-10 will affect the governmental healthcare programs. In addition to implementation compliance timelines, there are links to CMS industry e-mails, agency-sponsored teleconferences, and resources for providers.
Medical Group Management Association:
- Main page for ICD-10–related information. Resources such as webinars, checklists, and vendor questionnaires are available. Some may only be accessed by member practices.
American Medical Association:
- This site has lists of AMA materials on ICD-10, including books and magazine articles published, FAQs, and links to educational resources both from the AMA and elsewhere.