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Medical Billing and ICD-10 Coding Are Not a Game of Chance

February 21, 2013

Medical Billing and ICD-10It’s been a busy week at M-Scribe Technologies. Medical billing is an essential component of running a successful medical practice. When you specialize in coding, billing and EHR technology, you should make sure the job is done correctly the first time.

One of our new clients called with an often-asked ICD-10 billing question. “When should we consider preparing for the ICD-10 transition? We have until October of next year. Is it too early to be thinking about it?”

Our professional opinion is that everyone involved in patient care, medical documentation, and medical coding, should be familiar with the changes that are going to affect the industry in the very near future.

It’s like the old adage; “A stitch in time saves nine times the work.” Preparing beforehand for changes in the medical reimbursement industry will always result in increased cash flow and accurate reimbursement. Some smaller practices attempt to adapt to industry changes on their own, waiting until the last minute — resulting in frantic scurrying to catch up with the competition. Outpatient medical practices that employ a professional billing and documentation service have the advantage. They earn more by submitting cleaner claims with fewer denials or appeals.

There is such a thing as being pennywise and pound-foolish. It may cost money to hire a professional biller, but that decision will earn more money for the practice than its cost factor. The success of any outpatient medical practice depends on the billing. When billing is accurate and compliant, more money goes into the bank.

As with every profession, a medical biller needs the right tools to get the job done. With the increased automation the industry is undergoing, software programs used to submit healthcare claims need to be constantly updated to meet changing data requirements.

One of the recent requirements that every medical software vendor had to meet was the 5010 conversion. This action was mandated by the Patient Protection and Affordable Care Act of 2010 (PPACA). While everyone has heard of the new legislation that is changing the delivery of healthcare in America, and every healthcare provider is aware of the ICD-10 conversion, few people realize how far reaching these changes will be.

Billing software and interfacing electronic medical records that are 5010 compliant are also ICD-10 compliant, but what does this mean to an outpatient medical practice?   

A healthcare provider cannot be expected to master all the information technology and coding methodologies that go into modern medical billing. It is a confusing field full of specialized terminology and advanced concepts. A healthcare provider should spend the majority of their time treating patients. Other professionals should worry about submitting clean claims for payment.

Is today the right time to prepare for ICD-10? Our answer is a bit more urgent than 2012, but it is a resounding “Yes.” The transition from ICD-9 diagnosis coding to ICD-10 coding will take place on October 1, 2014 — there is no time like the present.

At M-Scribe Technologies, we continue to test and upgrade our software for our clients. Our staff of medical documentation professionals, certified coders, and experienced, qualified medical billers are trained and ready to make the transition to the new diagnosis codes. Some practices will be caught unprepared. Our clients know that we are equipped — if we are prepared, so are they.



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