Last year, on October 1, 2014, 82% of healthcare practices were not fully prepared for what was then thought to be the ICD-10 implementation deadline. CMS has made it clear that implementation will indeed happen on October 1, 2015. CMS has also made the ominous prediction that many home health organizations will be put out of business due to delayed reimbursements caused by inaccurate coding. Others, will likely see steep drops in revenue and staff sunk in coding rework making it difficult to keep their focus on client care. Time is getting short to implement a full-fledged ICD-10 transition plan. Intensive organizational wide implementation efforts must be put into place immediately!
What About the ICD-10 “Grace Period?”
On July 6th, CMS announced several concessions that constituted a 12-month grace period of sorts. Some homecare agencies may suppose this means they can still use ICD-9 codes for 12 additional months. However, putting your head in the sand and thinking this is simply false. The “grace period” is very limited and marginal in nature. It only allows for lack of “full specificity” in certain situations, and all codes must be accurate using the new ICD-10 format. Thus, after a delay in 2013 and again in 2014, there are no signs that CMS is backing down in 2015. Only those who successfully adapt to the coding changes and have carried out an ICD-10 implementation plan will survive and prosper.
How To Best Prepare for ICD-10 Implementation
There are a multitude of ways to prepare for ICD-10, which will affect your entire organization. Even though implementation is but a few days away, the coding changes will effect productivity, current processes and coding compliance for many care episodes to come. Listed below are 5 elements every home health organization will benefit from if included in their transition plan:
1. Form a Transition Team
While the entire staff will be touched in some way by ICD-10, forming an transition team who have been extensively trained and are knowledgeable about ICD-10 is essential. These team members will understand the need for expanded clinical documentation, the importance of coding accuracy which is vital for quick reimbursement. This strategy allows a select few to guide the transition process, identify and educate others struggling with the ICD-10 changes while continuing to focus on client care.
2. Implement Agency-Wide Training
Training sessions, organized and led by the transition team, need to be structured for specific job responsibilities. Because the implementation date is just weeks away, most likely ICD-10 education is complete, but it is important to repeat crucial information several times. Adult learners often don’t “hear” everything the first time or remember what they learned until the information in needed to fulfill their job responsibilities.
3.Dedicate a Transition Budget
There are costs associated with complying with ICD-10 – required education, software updates, and decreased productivity. Reimbursements from CMS and insurance companies will most likely be delayed following implementation. Consider securing a line of credit to prevent cash-flow disruptions and budgeting for these eventualities ahead of time.
4. Emphasize Major Coding Differences
The new code will contain over 68,000 individual entries, making it impossible to memorize them all. Experts suggest identifying 50 to 100 codes used most often by your organization. Align the ICD-9 with ICD-10 entries to compare, but be aware that several ICD-10 codes will generally correspond to one ICD-9 code due to the greater ICD-10 specificity.
5. Focus on Proper Documentation
Documentation practices will need adjusting to ensure accurate, compete clinical records required to code correctly in ICD-10. Coders cannot “guess” the home care diagnosis, assign complete 7 digit codes or submit claims without complete clinical documentation.
While preparing for ICD-10 implementation is non-negotiable, many organizations have found it is more profitable to outsource their coding duties. Kenyon’s Coding Plus program offers skilled experienced coders, OASIS and care plan review tools, and a 2 business day turnaround promise that differentiates our services.
October 1st is approaching fast! Contact us today or call call 206-721-5091 to ensure you are ready! You can’t afford to be unprepared!