Why does my Practice need ICD-10?
There is no room in the current ICD-9 structure for new diagnosis codes, or to re-classify existing codes. With the new ICD-10 structure, it allows for new diagnosis codes as well as the reclassification of existing codes. Along with the overall ICD-10 structure, the codes themselves allow for more specificity. In some cases the specificity of one code can state the ailment, location and how the ailment happened. The codes now have up to seven spaces, unlike the current ICD-9 codes which have five.
The Impact of ICD-10 on a Physician Practice
Front Office – Impact of ICD-10
ICD-10 impacts all aspects of a practice. The front desk will need to be aware of the changes that are happening, as well as be trained on how to answer questions from possibly irate patients in a calm manner. With the changes of ICD-10 it is possible that patients will be receiving bills from their insurance carriers in error. The front desk needs to know how to address these questions/complaints and in lay person’s terms explain that there is a change happening with the way things are billed to the insurance companies, and that the office will assist in straightening the matter out. This will not only alert the patient that there is a change happening in the background, but also put the patient at ease.
Mid-Office – Impact of ICD-10
Physicians will also be impacted by this change. With the new level of specificity in the diagnosis codes the chart notes will have to support the selection of diagnosis code(s). This means there will need to be more detail within the notes, as it is projected that insurance companies will be requesting supporting documentation for the claims being processed. If the documentation does not support the code selected it will most likely be the case that the insurance company denies the claim. Another reason the increased amount of detail is required is when the practice has a biller that codes the claim or a Medical Billing Service. If the documentation does not accurately reflect what was done, then the coders cannot accurately bill for that visit.
Back Office – Impact of ICD-10
The billing staff will also be impacted greatly. Currently with ICD-9 codes billers can easily use a number pad to type in their numerical codes, which allows for fast coding. Since ICD-10 codes are now alphanumeric, the coders will be slower to enter each code as they will have to go from the keyboard to the number pad multiple times. This in turn will slow down the productivity of the billers. Fortunately for those who are using a Medical Billing Service this loss of productivity will not be an issue as there are always multiple people working on an account. The other impact that ICD-10 will have on billers is they will now have to learn more about the anatomy they are coding for. Since there is a higher level of specificity they need to have intimate knowledge of what they are coding for.
ICD-10 is not merely a code change, but it is a process change as well. ICD-10 is aimed at improving healthcare by tracking specific conditions. In doing so Chart notes and questions that might otherwise be overlooked will now need to be asked. ICD-10 will have a major impact on all practices, but with the right preparation, any revenue or productivity loss can be kept to a minimum.
