Archive for February, 2015

February 26, 2015

Time to Update your ICD-10-CM Implementation Plan by Teresa Northcutt

Time to Update your ICD-10-CM Implementation Plan

ICD-10 is scheduled for October 1, 2015 – but after so many delays providers are nervous about whether that date will remain firm.  CMS and HHS are both affirming that the ICD-10-CM/PCS compliance date will not be delayed again, and Congressmen, previously on the fence regarding ICD-10-CM, are now strong proponents. However, after the last-minute vote on March 31, 2014 to delay last year, many are waiting until April 1 to re-start their ICD-10 transition plans.  That will allow only 6 months to prepare for this monumental change!  Providers, including home health and hospice agencies, must balance the time and costs of preparation with the need to be fully ready to comply with ICD-10 when it finally is a reality.

March-April 2015:

Update your agency’s gap analysis:  where are you with reviewing and revising processes that will be affected by ICD-10?  If you have intake, clinical assessment and documentation, QA review, coding and/or billing processes that are slow or inefficient, that will only be exacerbated when you add the changes ICD-10 will bring.  What do you still need to do to be ready for ICD-10?  We know choosing accurate ICD-10 diagnosis codes will require more detailed information than we currently get from many referrals and clinicians, so consider revising your intake process and/or forms to obtain more complete information from referral sources especially for diagnoses that will require more detailed coding in ICD-10.  Another priority is to improve your clinical staff’s knowledge of anatomy, physiology, and pathophysiology, sharpen assessment skills and enhance documentation details to meet current CMS requirements and coder information needs for ICD-10.  Have your coders completed a comprehensive ICD-10 training?  How long ago?  Do they need a refresher?  Have they had opportunities to practice coding in ICD-10?

Selman-Holman & Associates offers online training through Code Pro University to meet your clinical education needs:

  • Anatomy, Physiology and Pathophysiology modules offer an update to ensure accurate assessment and understanding of diseases, arranged by body system.
  • Documentation Update modules provide pointers to meet CMS requirements for homebound status and skilled need, and analyze the details that clinicians will need to document so coders will be able to select appropriate specific codes in ICD-10.
  • These modules are also helpful for intake staff to identify the specific information they will need to obtain from referral sources.
  • Coders may also benefit from an A&P and Pathophysiology refresher to navigate the intricacies of ICD-10 codes.

May-June 2015:

Finish up A&P and documentation training for clinicians, have coder/reviewers identify clinicians that need further work on their assessment and documentation skills to meet the expectations of ICD-10.  Complete revising intake forms and processes to ensure you obtain all needed details at referral.  If your coders did their initial ICD-10 training back in 2013 or 2014, focus on a refresher on the ICD-10 coding guidelines.  Now is the time to allow coders time for practice to gain speed and proficiency in ICD-10 coding.  If you haven’t started dual coding (that means scheduling time for coders to code some cases in both ICD-9 and ICD-10), that is a priority!

Selman-Holman’s Code Pro University offers comprehensive ICD-10 training for home health and hospice coders:

  • Modules outline the coding conventions and chapter specific guidelines, with plenty of home health and hospice practice scenarios, rationale for the coding and sequencing selected.
  • Quizzes are offered within the modules to test your understanding of the material presented. Go at your own pace:  if you miss a quiz question, you can go back and review any portions of the module as many times as you like.

July 2015:

Your process revisions should be implemented or ready for implementation on October 1.  Intake staff should know the additional information they will need to obtain for some diagnoses.  Clinical staff should be able to assess and document to meet the needs of ICD-10 coding, and coders should be familiar with ICD-10 coding guidance and practicing to gain speed and proficiency.

August-September 2015:

If CMS follows the same plan proposed in 2014 (file the RAP in ICD-9 before Oct. 1 and final bill the episode in ICD-10 after Oct. 1), agencies will need to begin dual coding all episodes that are anticipated to end on or after October 1.  Coders will likely be slower – do you have additional part-time coding help or an outsource coding company ready to deal with overflow?  Take care of any last minute issues to resolve.

Selman-Holman’s CoDR—Coding Done Right provides coding and OASIS review for home health and hospice by experienced certified coders.

October 1, 2015:  you are ready and able to comply with ICD-10-CM!