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Practices Plan for Coding Changes

Kurt Ullman  |  Issue: October 2011  |  October 7, 2011

It still seems to be a long way off—the changeover to the International Statistical Classification of Disease, 10th Revision (ICD-10) doesn’t become mandatory until October 1, 2013. But when you consider that practices need to look at computer systems, billing methods, and even patient welcome packets, that date is a lot closer than many think.

“There is no silver bullet that will get a practice through the implementation of ICD-10, preparation is the key” says Antanya Chung, CPC, CPC-I, CRHC, CCP, director of practice management at the ACR. “If you thought it was crazy trying to work through Y2K, implementation of the new coding systems may surpass that. Policies, information systems, even the patient’s welcome packet will need updating.”

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Version 5010

Until now, much of the focus has been on the first deadline when Version 5010 comes active. This is how various computer systems correspond with each other using standards for electronic health information exchange. Since this has to be live by January 1, 2012, all practices should be in the final stages of implementation.

Lynette Byrnes is the practice administrator for three Rheumatology Associates of Long Island facilities located in Suffolk County, N.Y She is currently involved in getting Version 5010 ready to go before the deadline. She is hoping that her experiences are not a prelude to what happens in 2013.

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“Early testing of Version 5010 is not going well,” she says. “I am not sure if our batches are getting to our clearinghouse and then to our payers. Once I get 5010 running smoothly and I know I can get paid promptly, then I can turn more of my attention to the problem of ICD-10.”

The practice is a beta site for both their clearinghouse and software vendor. Although being the guinea pig probably added extra time and effort, Byrnes thinks it was worth it because she knows for certain that Version 5010 will work with her particular computer and software system.

Now most of the focus turns towards ICD-10 itself. While much of this seems to be pointed toward the office staff and coders, Chung stresses there is need for the physicians in the practice to stay closely involved as the process unfolds.

What Physicians Need to Know

“Physicians need to immediately educate themselves in the nuances of ICD-10,” says Chung. “There will be major impacts on both the clinical and business sides of the practice that the physicians will have to work on. They need to look at the financial aspects of changing or upgrading systems, training, and to budget for operating capital if there are problems and they don’t get paid for a while in 2013. The other side is the level of detail involved in documentation and billing, which may decrease productivity and reimbursement.

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Filed under:Billing/CodingPractice Support Tagged with:BillingCodingICD-10Practice Managementrheumatologist

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