Then, on October 1, 2012, there will be limited code updates to both the ICD-9-CM and ICD-10 code sets to capture only new technologies and diseases. To help ease the final transition, there will be a very limited code update on October 1, 2013. There will be no updates to ICD-9-CM, as it will no longer be used. On October 1, 2014, regular updates to ICD-10 will begin.
Although there is much general work that can be done, such as getting systems in place, developing budgets, reworking policies and procedures, and planning training sessions, much of the nuts-and-bolts work is frozen until the codes are fully implemented.
“While we are starting to plan for the changes in coding, we don’t want to go too far too early,” says Brazeale. “Until the codes are frozen, coders may have to ‘unlearn’ some things if there are changes. If we start working with the codes too early, all we are doing is giving people a chance to forget them when they actually need them. We’ll probably start this part of the plan around January 2013.”
One group that should consider working with the interim codes now is the physicians. Chung suggests they sit down with their current charts. “From the doctor’s standpoint, it is all about making sure that documentation is up to par,” she says. “They need to take their charts as they are now and compare them with the guidelines and conventions for ICD-10. If you can’t match them up, you are definitely not ready and have some work to do.”
Financial Planning
The practice partners and owners should also be making financial planning decisions. Although there will be ongoing outlays for equipment, software, and training, the real danger to the viability of the practice will happen when payments will no longer be based on ICD-9 protocols.
There is little agreement on how well the switch will go. Some think it will end up like Y2K where most of the kinks are worked out successfully during the runup and the actual day of reckoning passes with little fanfare. Others suggest that prudent physicians should have as much as six months of income available through savings, loans, lines of credits, or other financial methods—especially since being ready is only one part of the equation.
“There are just so many layers to go through to get paid and they all have to work together,” says Byrnes. “Maybe I can get my batch to the clearinghouse, but if they can’t pass it along to the payer, I am still not going to see any money. I can do things perfectly, but if the others don’t do theirs, I am going to have find money real fast.”
