June ICD-10 Action Items
by Leigh-Ann Renz, 6.29.15
Meeting ICD-10 Compliance for Mental / Behavioral Health, Psychiatry and Substance Usage
June Item #1: Test With Your Payers
If you haven't started already, you should begin testing ICD-10 diagnosis codes with your payers in June. October 1st will be here before we know it, and you'll want to have the summer to retrain your staff and change practice policy, if needed, to address any issues that testing reveals.
Testing will also give you a concrete understanding of how prepared your various payers are for ICD-10 and how they might handle any problems that come up during the transition. Since payer reimbursement is the pivot that ICD-10 hinges on, having excellent communication with them, including testing, is essential.
June Item #2: Focus on Reducing Denials
The cautionary word on the street is that practices should have at least six months of cash reserves on hand to weather the potential reimbursement bottleneck that ICD-10 may create. Whether this will happen - and/or whether or not it's realistic for a practice to have that type of cushion - we don't know.
What we do know is that engaging any methods possible to increase income and reduce expenses is always necessary - and may prove crucial during the ICD-10 transition. Even simple measures like putting a freeze on unlimited office supplies or making sure your employees aren't making unnecessary photocopies can add up for your bottom line. Do what you can, and hopefully the reimbursement backlog will not be as detrimental as feared.
One straightforward cost-cutting measure you can implement now is have your billers focus on reducing denials. As you probably know, denials represent a huge missed income opportunity - and are sometimes caused by simple mistakes such as missing or incorrect demographics. "Even the best-performing medical practices experience a denial rate of 5%(1), and only one out of three providers (35%) appeal denied claims (2)."
Click here for a complimentary webinar about the four key areas where the claims process typically fails - and how to clean claims up to reduce denials and increase reimbursement.
ICD-10 Resource Center
ICD-10 Provider Training Webinar Series for Mental & Behavioral Health
8 Steps to a Smooth ICD-10 Transition
CMS ICD-10 Center
Previous Action Items
(1) Medical Group Management Association, Performance and Practices of Successful Medical Groups, 2013.
(2) Medical Group Management Association, A/R Problems and How to Fix Them, Blog Post, November 9, 2011.
(Disclaimer: Ultimately, it is the responsibility of each practice to ensure ICD-10 compliance. PIMSY EMR/SMIS has gathered information from various resources believed to be authorities in their field. However, neither PIMSY EMR/SMIS - nor its employees - nor the authors - warrant that the information is in every respect accurate and/or complete. PIMSY EMR/SMIS assumes no responsibility for use of the information provided. Neither PIMSY EMR/SMIS - nor its employees - nor the authors - shall be responsible for, and expressly disclaim liability for, damages of any kind arising out of the use of, reference to, or reliance on, the content of these educational materials. These materials are for informational purposes only. PIMSY EMR/SMIS does not provide medical, legal, financial or other professional advice and readers are encouraged to consult a professional advisor for such advice.)