ICD-10: Ignorance is Not Bliss – Part 2

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The ICD-10 compliance date of October 1, 2014 draws nearer every day. While many individuals in healthcare believe this initiative to impact only coders and billing staff, that misconception will certainly prove detrimental on many levels. All involved in the patient care experience will be impacted, even the patient (as introduced in ICD-10: Ignorance is Not Bliss – Part 1.) In Part 2 of this 4 part series, we will continue to follow our patient through her post-ICD-10 experience. When we last left off, Doris Jones was waiting for an exorbitant amount of time in the clinic waiting room to see her doctor. After an hour, she is finally checked in and called back by the Medical Assistant.

Scenario: Please Visit Ignorance is Not Bliss – Part 1 for Mrs. Jones’ situation.

Now let’s see just how this change really can affect everyone…

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ICD-10: Ignorance is Not Bliss – Part 1

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By now, most individuals working in Healthcare have heard of ICD-10. The varying degrees of familiarity with the new diagnostic and procedure code set are as varied as the individual reactions to its upcoming required implementation. Some individuals shudder in fear as the diagnosis codes leap from ~13,000 codes in ICD-9 to ~60,000 in ICD-10 (not to mention the ~76,000 procedure codes that will now be required for use in the Inpatient environment.) Some individuals (certainly most coders and billers) can not sleep at night knowing the learning curve, productivity slowdown, and likely revenue loss that this initiative will certainly yield. Perhaps most disturbing, however, is that many individuals (including providers) believe that ICD-10 will not have an impact on their staff, their work, their finances, or the patient experience.

That, unfortunately, is a scary and fallacious understanding of what is ahead. ICD-10 will impact everyone. To make the point, I offer an example of a basic patient office visit.

Continue reading: ICD-10: Ignorance is Not Bliss – Part 1

I’m a Doctor. I treat Patients. Knowing ICD-10 codes is the Coder’s Job!

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The title of this article seems reasonable and appropriate. Unfortunately, it is patently false!

By now you are probably likely acclimated to (perhaps even enjoying!) the ‘touch once’ method of encounter documentation, in which you dictate, click and/or type through patient visit documentation. Once the patient leaves the office, you are 100% done with the documentation. Although this may not always be possible, this serves as the preferred method to complete your charting.

With the impending changes that ICD-10 will bring, you are all but assured of the requirement to re-touch a large number of your charts if you have not been properly trained in the methodology of ICD-10 billing.

What does this mean? Why is this?

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ICD-10 Training Timeline: Are You Already Behind the Curve?

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ICD-10 looms over Healthcare in America ominously. Many studies project that a tremendous number of ambulatory medical practices will have very significant cash flow shortfalls . Many of them actually may declare bankruptcy, because of the draconian changes in the required billing processes on October 1st, 2014.  A number of sources of information, including the Federal government at CMS, as seen at http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10SmallMediumChecklistTimeline.pd encourage immediate action!

Don’t get caught short.  Arm yourself with the  knowledge that will prove vital to your practice.  Just as it took a year to learn anatomy, it will take your office a year to undertake the painful migration to using ICD-10 for all of your billing.  To state the obvious, if you are not using ICD-10 for all medical services on or after October 1st, 2014, you will not be paid!

To state the less obvious, this is not an issue only for your billing department.  You, the physician, will need to either:

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ICD-10: The Price of Ignorance

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You’ve just been through the nightmarish attestation process for Meaningful Use Stage I and Stage II.  Perhaps, you have even received the sought after Federal stimulus dollars.  Even worse, you’ve struggled through the transition to become a meaningful user of a certified Electronic Health Record, but you haven’t quite caught up yet.  You purchased the wrong system at first and are migrating from one system to another.  Sadly, this is an extraordinarily frequent problem.

You deserve a break.  Unfortunately, with upcoming compliance initiatives , shifting government policies, and Meaningful Use Stage III right around the corner, this can not be so. Now comes an equally daunting task, and one which puts your entire practice’s finances at even more risk than did the migration to an EHR.

As you probably have heard, you will not be paid for any medical services that are provided on or after October 1st, 2014, unless you bill for them using the ICD-10 code set.

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You’ve Been Scanned

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In the world of Information Management there are many options to choose from when it comes to the transition from hard copy documentation to digital documentation and often that leads to “Decision Overload”, a common symptom when there are too many options provided for a simple need. The cure for this problem is prioritization. Easily said but not so easy to do. The first step is to clearly understand the objectives and when it comes to scanning hard copy files into digital formatting, there are 6 primary objectives.

  1. Discard promptly records you no longer need
  2. Improve retrieval of records by reducing their bulk
  3. Reduce staff time needed to access records
  4. Save money by reducing storage costs
  5. Save space by freeing up filing cabinets and storage areas
  6. Identify and, therefore, preserve permanent records

In the spirit of simplicity, taking one bite at a time is a great process for prioritization! LAUREN PERKINS is a branding and digital marketing expert who suggests the following steps in BOLD for prioritization:

  • Make a List: Lauren suggests that you make a list. You could start with the 6 objectives stated above and then categorize them into urgent vs. non-urgent to determine the top priorities.
  • Assess the Value: Completing certain tasks will offer more benefits than others so I would suggest that the greater value is based on the tasks that more closely effect your customers. If the task helps you more readily serve your customers then that has greater value then tasks that focus on only the internal benefits.
  • Be Flexible: To be able to effectively prioritize, it’s important to be able to manage changing priorities. Many factors pull us in a variety of directions, so take them as they come and decide what has the greatest urgency and go with it.
  • Cut the Cord: This is probably the most difficult one for most of us to work with. Many of us are “Get-The-Job-Done-r’s” and find it difficult to rely on others when a job needs to get done right and done on time. However, finding a trusted alliance partner that follows through with what they said they would do is freedom beyond compare! When you find that person or company, cut the cord from the project and let them help you build the business or practice!

So now “You’ve Been Scanned” and I hope you have found it helpful. I look forward to you visiting us again when we discuss “The Virtues of Accountability”.

Where will it all end? A commentary on the EHR industry.

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So, I’ve been following the EHR industry for a couple decades, and have been very intimately involved for 7 of them. In 2004 I started the process of cataloging all of the then commercially viable EMRs. Yes, you’ll recall that they were called EMRs, or Electronic Medical Records back at that time.