General Surgery Coding Alert

Your work doesn’t end on Oct. 1.

Now that you have a grasp of what to expect as you move from ICD-9 to ICD-10, we have some other expert tips for you.

Here are some steps you can take to keep your general surgery practice on the straight and narrow as you work to implement the new diagnosis code set.

Focus on Education

When preparing for the imminent transition from ICD-9 to ICD-10, “education is the biggest thing,” stresses Angie Comfort, RHIA, CDIP, CCS, senior director of HIM Practice Excellence, Coding Services, for the American Health Information Management Association AHIMA).

Who should you train? Anyone who touches patient records or submits billing must be trained for ICD-10, Comfort says.

“The level of training would be based on the role the staff has as it relates to working with diagnoses coding,” notes Michelle Cavanaugh, RN, CPC, CANPC, CGIC, CPB, CMRS, an AHIMA-approved ICD-10 trainer and RCM manager at Kareo.

Clearly that means coding and billing staff, but you shouldn’t stop there. Ultimately, the responsibility for coding accurately for the patient’s condition rests on the physician. That means your general surgeons must understand what new information they need to document in their reports to allow compliant ICD-10 diagnosis coding. “Taking the time to learn the new coding system as it relates to their specialty will benefit them in the long run,” Cavanaugh says

Practice Dual Coding

Try “dual coding” claims using both ICD-9 and ICD-10 codes, for extra coding practice between now and October, Comfort suggests. If you’re able to and have the time, you might consider practicing dual coding a couple hours once per week. Start with your most common condition codes, based on your practice mix. For instance, you might start by dual coding all hernia and breast biopsy and excision cases, if those represent a large percentage of your surgical work.

Beware efficiency: You should keep track of the time it takes to code records using ICD-10, to determine if there’s a decline in coding productivity, Comfort says.

Loss of productivity during the initial implementation period is a big concern for practices. That’s why you should plan a budget focused on the 2015 fourth quarter “to allow for a dip in productivity and the unknown about how smoothly the claims are going to be adjudicated after October 1,” Cavanaugh says.

Watch Claims Results

Once October 1 passes you by, your ICD-10 transition work isn’t over. At that point, you need to start monitoring all your claims to make sure your payers are reimbursing them correctly. With this major transition, you “must be more diligent about monitoring claims,” Comfort advises.

Late-breaking tip: Medicare has stated its intention that, for the first 12 months following ICD-10 implementation, the agency will not deny claims due to lack of diagnosis specificity. Find out more in upcoming issues of General Surgery Coding Alert.