For the most part, the largest U.S. healthcare providers have been very organized and prepared for ICD-10 implementation. Is there anything we can learn from their experience?
Embrace technology
New York University Langone Medical Center expects decreased productivity during and after the ICD-10 transition. One of the ways it can soften that hit is to help clinicians and medical coders with tools such as computer assisted coding (CAC) tools.
The Cleveland Clinic Health System is using its CAC system to help clinicians understand the ICD-10 transition and improve clinical documentation. It already has improved productivity, satisfaction and query rates.
Hire enough help
Again, NYU Langone expects decreased productivity processing medical claims and bills. They already have hired more medical coders to keep workflow going.
And there needs to be efforts to keep those medical coders trained and satisfied. Keeping them on the job is much easier than replacing properly-trained medical coders after Oct. 1. ICD-10 coding will be a skill set in much demand next year.
Practice makes better medical claims
Methodist Hospital in Memphis has purchased an ICD-10 training tool that uses actual medical records. It teaches medical coders how to process the kind of medical cases in the DRGs that they encounter as part of work.
This makes dual coding much more efficient by making it directly part of training. That addresses some of the cost and productivity issues that have healthcare providers reluctant to code cases in both code sets.
Another option is the CAC system currently used by Children's Hospital Colorado that assigns ICD-9 and ICD-10 codes. This offers insights on how reimbursements and documentation may be affected after Oct. 1. It also gives medical coders guidance on how to assign ICD-10 codes.
Look for ICD-9 codes in unlikely places
Most healthcare providers know that they need to upgrade electronic health records (EHRs) and practice management systems (PMS) to accept ICD-10 codes. But there are some places that ICD-10 project planners may not be looking.
For example, Novant Health, a 13-hospital health system in Winston-Salem, N.C., found physicians who had research projects that tracked ICD-9 codes in spreadsheets. Unless those projects end Sept. 30, the physicians will have different sets of data — apples and oranges. There needs to be conversion of codes.
Perhaps that's a role that extra medical coders can do to help. Yes it is costly without a financial return on investment. But if medical coders can convert the ICD-9 codes in research to ICD-10 codes, that will give them practice and improve physician morale. And maybe that's what's needed to get acceptance rather than vigorous opposition.
Measure twice
Healthcare payer denials and rejections aren't unheard of now. So it's unlikely that ICD-10 glitches will cause all reimbursement problems after Oct. 1. Providers need to understand what is "normal" with ICD-9 coding to compare once claims are rejected with ICD-10 codes.
Novant health plans to collect this data three months before the ICD-10 compliance deadline. Then they have an idea whether the edits are something they can fix in house or through communication with healthcare payers.