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5 Signs Your Practice Is Not ICD-10 Ready

November 5, 2013

Is your practice ICD-10 ready?You’ve probably already marked your practice calendar for October 1, 2014. Yet, the ICD-10 implementation date is approaching faster than you probably want. Preparing in advance is critical to your ability to avoid reducing your income stream and enduring multiple rejected or delayed claims reimbursements.

If, for reasons difficult to defend, your practice has yet to begin preparations for the massive conversion from ICD-9 to ICD-10, it’s not too late. However, you must eliminate previous procrastination and take action now. The necessity of converting from around 13,000 diagnosis codes to around 68,000 codes, including optional sub-classifications, is even more difficult in the United States.

Along with the international diagnosis codes, the US has 76,000 procedure codes, which other countries do not use. If you believe the transition will be a leisurely “walk in the park,” you are deluding yourself. Transition problems are more serious than mere documentation cleanup will fix.

The revenue stream for your practice could be seriously reduced, at least temporarily. Further compounding the potential problem: ICD-10 codes are not merely a restatement of and additions to ICD-9 codes. There are numerous changes to the structure and underlying concepts of the ICD-9 system used in the US for so many years. You must recognize the symptoms and warning signs indicating that your practice is not ready to make this transition in less than 12 months.

Five Symptoms Your Practice Is Not ICD-10 Ready Now

  1. You have not built up some extra operating cash should reimbursements be delayed after conversion. Practice operating expenses will continue at or above current levels regardless of reimbursement revenue stream reductions. Stockpiling some extra cash will help smooth out the transition, addressing potentially inevitable delayed claim payments.
  2. The practice has not adopted a procedure for proofreading documentation to better ensure that ICD-10 claims are “clean” before submission. Along with thousands of new codes and structure changes, many payers will implement claim submission procedural changes. To minimize potential income shortfalls, having one or more staff members check all ICD-10 claims for accuracy before submission is a necessity.
  3. You have yet to begin intense, formal training for your medical billing staff. Since there are concept and ideological differences when transitioning from ICD-9 to ICD-10, the challenge of training your staff is complex. The many differences will not permit a quick, crash course for your staff. You’ll get much better results by having less pressure-packed training sessions now on a regular schedule.
  4. If you have, at least, started training, you have not scheduled or implemented multiple staff tests to measure employee understanding and retention. Early testing and repeating tests during the training process are necessary to ensure your employees understand the new coding system. Dispensing information to staff is imperative. Having your employees retain training information is equally vital–if not more so.
  5. You have yet to evaluate or negotiate with a top third-party medical billing firm, such as M-Scribe Technologies, to assist internal staff in submitting accurate claims to payers. If your practice wants to minimize additional expenses, while ensuring you submit claims accurately, a premier medical billing service is the best option. These firms will have the best trained personnel at implementation date, along educating their staff on multiple payers’ claim procedural changes.

These are some significant warning signs your practice may not be ready for ICD-10 conversion. Fortunately, you have time–if you start now–to treat these symptoms and heal them. Your practice cannot afford to suffer rejected and/or delayed claims.

There are no good reasons to allow this to happen. Plan to be ready; then, execute your plan. Don’t wait–do it now. You’ll keep your income stream cranking at top efficiency.


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