Ready or not, the ICD-10 deadline will be arriving shortly.
The Centers for Medicare and Medicaid Services (CMS) has established October 1, 2015 as the compliance date for ICD-10 implementation. Healthcare organizations will need to submit claims with ICD-10 codes.
ICD-10 adoption is a challenging and with a pressing deadline. Here are 3 things you can do to prepare for ICD-10:
1. Risk Assessment
A good way to identify this financial risk is by using analytics software, such as the HL LEAP I-10 software. Take your historical 837I claims and simulate 837I with ICD-10 codes. Through this predictive modeling you are able to:
Identify where there are DRG shifts, why these shifts are occurring and most importantly what to do to prevent the shifts.
Begin your analysis by looking at high risk, high volume, high dollar DRG shifts. Easily identified with analytics software.
Validate and categorize your risk. At HL we have developed a claims analysis methodology. We have identified three reasons why DRGs can shift: 1. true financial risk 2. due new coding guidelines, and 3. new documentation requirements.
As you begin to understand why the DRG’s have shifted turn this insight into meaningful action. Tailor and customize your CDI program and coding education program, identify charts for dual coding, and review. Make your time count.
If you do not understand where you have financial risk in ICD-10, how do you know what areas will be impacted? How do you know how to plan your remediation efforts? Looking under the hood today, are there areas that can be improved upon now? Use the extra time to assess financial risk and improve your bottom line today.
2. Adopt Provider Friendly Terminology, Workflow-Enhancing Search
Clinicians are compelled to use a structured vocabulary -- as opposed to their own, natural language -- when they document care using ICD-9 codes. That job becomes even more difficult under ICD-10, which adds thousands of new codes and higher levels of specificity. CMS states that ICD-10 will use 68,000 codes compared with the 13,000 codes used in ICD-9.
To ease the transition of ICD-10 and help physicians with documentation at the point-of-care, health organizations will need to find a way to map the clinicians’ favored terms to the appropriate ICD-10 codes. Utilizing Provider Friendly Terminology, or PFT, solves that problem. A PFT content set contains the essential elements -- synonyms, colloquialisms, abbreviations, and common misspellings -- of the non-standard language clinicians commonly use. Health Language has added PFT to the standard terminologies available through its enterprise terminology management platform.
PFT allows a healthcare provider to use the clinical language he or she uses every day when inputting data in an electronic health record (EHR) system. In this approach, a physician enters a synonym, colloquialism or abbreviation into an EHR to record a diagnosis and the PFT solution automatically translates that information into the appropriate ICD-10 code. PFT reduces the clinicians’ learning curve and saves time, which will ease the transition to ICD-10.
Health Language offers Workflow Enhancing Search as part of its enterprise terminology management platform.
3. List Mapping - Prepare for the Future
The conversion to ICD-10 doesn’t end with the October deadline. Standard terminology sets such as ICD-10 go through revisions; updates will continue to emerge over time. By representing any lists of ICD-10 codes as code groups, you make it easier for your organization to incorporate updates as they become available down the road. A terminology management solution facilitates the task of keeping code groups up to date, offering centralized management and sophisticated tools.
Are you ready for the ICD-10 conversion? Leave your comments below.