CMS’s 3 September Steps to ICD-10 Implementation Readiness
By - 26 days remain until ICD-10 implementation becomes reality for the healthcare industry. The Centers for Medicare & Medicaid Services (CMS) has announced the following series of quick “ABC” ICD-10 implementation readiness tips to follow within the month of September:
A is for “assessment” of practice needs
According to CMS, it is imperative to assess now how ICD-10 will affect your healthcare practice come October 1, and beyond. CMS additionally recommends figuring out what particular areas are best to focus on with immediacy – namely clearinghouse services and their role within the ICD-10 transition, coding training, clinical documentation training, new forms, systems upgrades, and ICD-10 code access. CMS points to code books, electronic health record (EHR) products, phone apps, practice management systems, etc. to obtain available codes from a variety of sources among a multitude of formats.
CMS additionally advises identifying areas within your practice where ICD-9 codes are used to increase awareness about ICD-10 updates. Such areas include patient registration and scheduling, clinical documentation and health records, referrals and authorizations, order entries, coding and billing, and reporting and analysis. A lack of ICD-10 preparation means increased risk of cash flow, CMS maintains.
B is for “being sure” systems are ready
Bluntly put, “Be sure your systems are ready,” CMS says. Test systems and processes and verify claims can be generated, CMS advises. It is essential, says CMS, to make sure your ICD-10 systems are ready to complete the following actions:
- Generate a claim
- Perform eligibility and benefits verification
- Schedule an office visit
- Schedule an outpatient procedure
- Prepare to submit quality data
- Update a patient’s history and problems
- Code a patient encounter
CMS confirms clearinghouses and billing services can conduct Medicare acknowledgement testing. Additionally, many leading health plans confirm the use of portals for those healthcare providers who cannot submit electronic ICD-10 claims. Give your staff ample time to complete free training on billing software portals, CMS says, and be sure to register for each MAC portal used.
C is for “contacting” your vendors
CMS confirms, “Now is the time to get ready.” CMS additionally advises contacting software vendors, clearinghouses, and billing services. “Ask about testing and training opportunities,” says CMS, and “confirm vendors and services are ICD-10 ready.” CMS specifies the following tips:
- Call your vendors to confirm the ICD-10 readiness of your practice’s systems
- Confirm that the health plans, clearinghouses, and third-party billing services you work with are ICD-10 ready
- Ask vendors, health plans, clearinghouses, and third-party billers about testing opportunities
CMS also requests reviewing all systems using ICD codes – such as practice management systems and EHRs – when communicating with vendors, updating vendor and health plan contracts as needed, and recognizing transition costs for smaller medical practices “could be substantially lower” than was once projected – many EHR vendors, for instance, are incorporating ICD-10 within their systems or upgrades at little or no customer cost.
