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ICD-10-CM: Knowing is Half the Battle
There will be many changes coming down the road for ICD-10 implementation and many transitions you will be unable to do on your own. Communication with outside vendors will be essential to successful ICD-10 transitions.
A vendor communication plan will assist you in making sure that you cover all your bases. Start by pulling all your vendor contracts and make a listing of how the system/organization will impact ICD-10 implementation in your practice. A simple Excel spreadsheet is great for this purpose. First you will want to reach out to your vendors and assess their ICD-10 readiness. Find out what their plans are and begin working with them on time frames. Find out how their changes will affect your practice and then begin to develop your own internal fixes and time frames for any changes the vendors will be implementing.
You contract with ABX Clearinghouse for claims submission. They will be offering ICD-10-CM testing beginning January 1, 2013. In order to participate in the testing you would need your practice management software updated and ready to go by this date. You could then adhere to their testing time frames and ensure you are ready to go live by October 1, 2013.
Here's another example:
Your practice utilizes ABN forms for Medicare. In order to update your policies and procedures internally you will need to reach out to vendors to see what changes they may be making to coverages. Once you obtain dates and information from the various health plans, you can begin to work on revising your internal policies and procedures to remain compliant. You will also need to schedule staff training as well.
Working early and communicating often with all outside vendors will be key to ICD-10 implementation. With careful planning you will be able to take the stress out of this large project.
IN THE NEWS
On December 8, 2009, the Centers for Medicare & Medicaid Services (CMS) assembled a listening session to hear from representative stakeholders in the health care industry. AAPC was a part of this informative session. After short presentations on CMS Version 5010 and ICD-10, stakeholders provided their views and insights about the industry's progress toward and concerns about implementation. These informational sessions help share concerns and ideas for ICD-10 and 5010 implementation efforts. The full report can be found on the CMS website.
An established patient presents for pulled tendon. Was playing field hockey earlier today, felt something pop in left ankle. Swelling, hurts to touch, hurts to walk, wearing brace he had with no pain relief.
Denies any constitutional symptoms. Musculo as above with no other complaints, all others negative
Previous history of broken collarbone
Family history of heart disease on mothers side
Patient cooperative, walks with a limp. No visible trauma, FROM, N/V intact. Tender medially ant trap tendon.
Sprain referral to ortho.
S93.402A, 793.65, Y93.328
Rationale: Index lookup: sprain, ankle
Code description: S93.402A, Sprain of unspecified ligament of left ankle
Index look up: activity, hockey, field
Code description: Y93.65 lacrosse and field hockey
Index look up: place of occurrence, sports area, field, hockey
Code description: Y92.328, other athletic field as the place of occurrence of the external cause
Note: In ICD-10-CM we need to know laterality and where the injury occurred as well as the activity of the patient when the injury occurred. The guidelines indicate that a place of occurrence code(s) should be listed after the activity code(s).
We will be sharing a number of steps to help your practice successfully implement ICD-10-CM. They are also found in your ICD-10 Implementation Tracker on AAPC's website.
Step #8: Contact System Vendors
Determine if your vendors will support the upgrade to ICD-10, and if they can support two code sets simultaneously (ICD-9-CM codes will need to be maintained for an unknown period of time to handle resubmissions, claim suspension, and denials until all old claims are resolved). Clarify the vendor's time line for testing and implementation. Make certain that you have scheduled the 5010 conversion and ICD-10-CM delivery date for installation and testing now.