Published 11/1/2013
Howard Mevis

Counting Down to ICD–10

Timeline and testing are key

The implementation date for shifting to the International Classification of Diseases, 10th edition (ICD–10) is less than a year away! If you have not begun planning for your office to make the switch on Oct. 1, 2014, you need to quickly establish and adhere to an accelerated timeline. Adopting the following schedule will help ensure that your office is ready to implement ICD–10 next year.

Dec. 31, 2013—Complete your review of all practice systems that currently use ICD–9 coding. These include your practice management system, your electronic health records system (EHR), and your picture archiving and communications system (PACS), as well as coding sheets, fee schedules, and other “back-office” materials.

March 31, 2014—Any new or updated software required to implement ICD–10 should be completely installed by this date. In addition, you should be completing all staff training and testing coding staff on ICD–10 coding procedures, nomenclature, and documentation changes. Note that 30 hours or more of training may be required for staff who work closely with these codes.

April 1, 2014—Start changing your documentation to incorporate the new ICD–10 terminology. Everyone who sees patients—including all orthopaedic surgeons in the practice, any other physicians in the practice, and ancillary health service providers—will need to change their patient documentation.

May 31, 2014—Conduct vendor tests with payers and claims clearinghouse. Review patient documentation changes.

Aug. 31, 2014—Fix any problems identified during vendor tests.

Oct. 1, 2014—Welcome to the ICD–10 era!

Vendor testing
As noted in the AAOS webinar, “Make Sure You Get Paid on Oct. 1, 2014: ICD–10 Readiness,” there will be no grace period in submitting claims. You will need to work closely with your information technology vendors on reviewing, installing, and testing software systems and information resources. Once you implement new software and test your systems, the next step is testing with your vendors.

Many vendors have completed their ICD-10 readiness or are engaged in this work. In addition, many vendors are updating security measures—and you should too! Enforcement of security measures under the Health Insurance Portability and Affordability Act has been strengthened and the penalties for violations are serious.

You and your practice executive need to establish a testing program with your claims clearinghouse and payers. Testing will help you identify and fix problems ahead of the implementation deadline. Contact your billing service and payers to establish a testing plan and schedule. If your vendors are not ready, ask for firm dates when they anticipate being able to conduct external testing.

Testing should involve several different claims, especially for musculoskeletal trauma, pediatric orthopaedics, spine, and musculoskeletal oncology. A key element of testing is reviewing feedback to identify problems and define solutions. Ask detailed questions regarding how the claim was processed—beginning at your office, through to the claims clearinghouse, and then by the payer. Each step needs to be analyzed, problems identified, and solutions developed. Your vendors may be a good source for solutions.

If you discover that staff training is your greatest problem, consider taking advantage of the multiple resources available from the AAOS, professional coding associations, and the government itself. Remember that if you employ certified professional coders, they will need to update their certifications to cover ICD–10. That also means they must be familiar with the entire coding system—not just coding for musculoskeletal conditions—and may require a refresher course in anatomy.

It’s not too late to sign up for the AAOS practice management webinar series on preparing for ICD–10. The third webinar, “Clinical Documentation Strategies for Orthopaedic Surgeons,” is scheduled for Nov. 21, 2013, and registration also gives you access to the two previous webinars. You can register at www.aaos.org/courses

Howard Mevis is director of the AAOS department of electronic media, instructional courses, course operations, and practice management. He can be reached at mevis@aaos.org

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