Thanksgiving Day is a time of feasting and family togetherness. It is a time filled with traditions, ranging from Grandma’s secret pumpkin pie recipe to father’s responsibility to carve the turkey and neatly separate it into white and dark meat on the “official” thanksgiving platter. No tradition, however, is more basic to this thanksgiving holiday than the call to count your blessings received during the preceding year and expressing thanks for them.
Is ICD-10 a Thanksgiving Blessing?
Thanks will be given for family, for continued good health, for the chance to live in the U.S., and for the provision of all our various needs. But hopefully as a healthcare provider, you have an extra item to give thanks for this year- successful ICD-10 implementation!
As 2015 draws to a close, the first quarter of claim submission using the “new” ICD-10 codes passes. Sufficient data is available to measure the mastery of greater code specificity and the reduction in denied or rejected claims. Managers have had time to identify which clinicians need additional education on obtaining adequate assessment visit documentation preventing rework and allowing correct code assignments. To count ICD-10 as a true thanksgiving blessing however, you must be capturing adequate reimbursements allowing for a profitable bottom line and growth for your organization.
The Marks of ICD-10 Success
Before considering ICD-10 implementation among your organization’s thanksgiving blessings, you first need to assess whether or not your ICD coding is measuring up. Some of the marks of your organization’s ICD-10 success are:
- You have no recent claim denials and your claims are seldom being sent back for revision and re-submission.
- Your claims are coded, processed, and submitted timely allowing for quick payment turn around, keeping your cash flow healthy and your bottom line out of the red.
- You are getting the maximum reimbursement for each claim, by coding for optimal case-mix weight, including full specificity.
- Your coders are certified and/or have received specific home health and hospice coding training.
- Clinicians are providing coders with adequate documentation without having to go back and gather missing information.
- Visit frequency and plan of care are determined and optimized prior to claim submissions.
- Your IT infrastructure and software runs smoothly with ICD-10, and your systems are integrated so as to save time, money, and effort.
- Your clinical staff is able to focus on client care while your medical coders remain efficient and productive.
What If My ICD Coding is Inadequate?
If you cannot count ICD-10 as a blessing this year, because you continue to grapple with the changes, have not mastered maximum reimbursement potential and aren’t maintaining a profitable bottom line, there are ways to correct the problem. First, you can hire certified, experienced home health or hospice coders, if you haven’t already done so. Or, you can invest in further training for your present coders. Also avail yourself of available resources, especially those provided by CMS, that can help you improve your coding efficiency.
Another course of action is to outsource all your coding to certified home health and hospice professionals. These experienced coders work every day coding numerous claims. You may opt to outsource on a temporary basis, while preparing your organization ready to handle coding on its own in the future. Or, you may find it more convenient and cost-effective to outsource permanently.
Kenyon HomeCare Consulting provides an outsourcing program known as Coding Plus. Schedule an appointment today to learn more about how you can take advantage of accurate, up-to-date coding practices allowing for maximum reimbursements completed by coders with 5 to 10 years’ experience. Additionally, benefit from help in optimizing your documentation process and monthly assessments in multiple areas to streamline agency efficiency.
Let us help you turn ICD-10 into a blessing this Thanksgiving season!