ICD-10, Bring it on…We are Ready
By Susan Ward, CPC, COC, CPC-I, CEMC, CPCD, CPRC
As the coding & billing manager of a small plastic reconstructive practice, I wanted to be sure we were ready when ICD-10 goes live. In our practice, we primarily deal with skin cancers, breast reconstruction for breast cancer patients, and breast reductions. Recently, my surgeon started taking trauma cases, which required an entirely new understanding of facial fractures.
What I found was that most of my doctor’s documentation was already supportive of specific ICD-10 codes. Having the documentation there to support the ICD-10 codes made it easy. I also noted that it did take me a little longer to code in ICD-10, but not to a point that would cause measurable disruption when we go live. I was able to sit down with my surgeon and review all the requirements we will need for ICD-10-CM long before implementation, so that his documentation will support laterality, location, and different fractures. We wanted to assure he also understands the use of 7th characters. We will continue to meet until the Oct. 1 implementation date.
When I read the email from our clearing house that they were looking for small practices to send test files using ICD-10, I got so excited you would have thought I won the lottery. I told my surgeon I was going to participate in testing, and he was just as happy as I was.
I sent in 12 test files. Not only did our claims pass at 100 percent with our clearinghouse, I was told that some of our claims were selected to test entirely through the CMS system. Being able to test with payers is extremely important to ensure we won’t have problems in October. It buys time for bugs to be found and fixed before we send real claims for reimbursement. This made our office feel much less anxious about ICD-10.
With the practice now using an electronic health record (EHR), I believe it is more important for our providers to understand which diagnostic codes they are choosing, and assuring that they are selecting the codes with the highest specificity that is supported in their documentation. Having the ongoing opportunity to review and discuss documentation guidelines and specificity with my providers has made a very positive experience, and gives me the comfort that we will be ready to code and submit clean claims on Oct. 1, 2015.