The big day for the ICD-10 transition is just around the corner. Practices should have been using their time to train, install hardware and test their software for compatibility with other entities with which they communicate. However, despite the best laid plans and intentions, clinicians may not be as ready as they think. Software systems are a prime consideration and there are steps that practitioners can take to ensure they’re ready when Oct. 1, 2014 arrives.
EMRs
There are dozens of EMRs available. They have multiple features, but clinicians are often required to pay extra for access to updates and other items that should be included automatically. Practitioners will want to ensure they have an EMR capable of handling the new codes and that they have the latest version available installed.
EMRs must have sufficient security measures for HIPAA compliance to safeguard patient information. Consult with vendors to verify that the EMR is HIPAA compliant, code upgrades are covered in any contracts, and if training will be included.
Crosswalks
A crosswalk offers a means of translating ICD-9 codes to the new ICD-10 version. It’s essential that any software include those crosswalks for translation, especially in the early months of the transition. If the EMR doesn’t support crosswalks, clinicians may need to invest in a program to assist with coding tasks.
GEMs
General Equivalence Mapping isn’t designed for long-term use, but it does provide a valuable resource. It’s a tool that can be used to assist in locating the correct code options and help staff become more fluent and comfortable with the new code selections.
Side-By-Side Coding
Until everyone in the practice is familiar with the new coding system, a side-by-side coding feature will prove very helpful. It will reduce staff frustration and help everyone rest easy knowing they’ve entered the correct diagnosis codes.
A system that allows clinicians and staff to incorporate the new coding into their everyday duties will help everyone become familiar with the new codes before the deadline. They can also begin using the new codes prior to the implementation date with entities that are ready.
Billing
It’s critical that in-house or contracted billing services are prepared for ICD-10. They must be compliant with the new HIPAA transaction standards for transmitting data electronically. Be prepared for a reduction in productivity, even with superior billers and coders.
Testing
Testing should include the ability to submit claims and insurance eligibility. The only way to ensure if a practice’s software is ready for the ICD-10 transition is to conduct exhaustive testing in those areas – then test some more. If any glitches or issues do exist, the more the system is used the more likely they will be to become apparent. It’s also important that inter-office systems can communicate with each other.
The software that transmitted a claim perfectly today has the potential not to work smoothly tomorrow. Continued testing is the only way to ensure that problems are identified and addressed prior to the deadline. If for some reason an issue can’t be fixed by implementation day, be sure to have a contingency plan. Relationships with new vendors may have to be established, so be prepared.
Significant coding changes will take place with implementation, but if the practice’s software can’t communicate successfully with insurance companies and clearinghouses to submit claims, they’re of no use and will cost clinics dearly in revenues. Implementation is more than just a coding change. It affects every department. Ensuring the clinic’s software is working correctly will make the transition easier while maintaining revenue levels.
