ICD-10 | Five Building Blocks | Q&A from Webinar
ICD-10 Questions and Answers ICD-10 is coming soon. As you get your practice ready for the ICD-9 to 10 changeover, you are bound to have questions regarding documentation and compliance. To help you get the answers you need, we have compiled all questions that were asked during our recent webinar “ICD-10 | Five Building Blocks,” along with the presenter’s responses. Feel free to add any new questions in the comment section below. Q: Where can I find CMS guidelines in written form? A: On CMS.gov, click on the Medicare link and you will find a link for both local and national coverage determinations. Q: When can I start finding ICD-10 codes within your software and submitting them? A: Our software already has all the ICD-10 codes listed; we are building the crosswalk now. We recently completed ICD-10 testing with Medicare, and were successful with our front-end edits. We are looking to have this available to practices by June, to really start testing and cross-walking. At this point, payers are not accepting claims with these new codes; they are not coming over until October 1, but we are testing with payers and clearinghouses directly. You will be able to see which ICD-9 codes correspond to the appropriate diagnosis 10 codes, side-by-side right in the travel card.
Ripe for Success
Software solution promises to be the “secret ingredient” By Kathleen Casbarro Will Ben’s new tech solution lead to the perfect outcome? “So…?” Carmen asked with an upward lilt that made it into a question, “how’s the documentation going?” “Thanks for asking,” Ben said, dropping a kiss on her nose. “I think it’s going to be good. You know I’ve been going back and forth a bit on how to approach the need for greater specificity in our documentation.” Carmen rolled her eyes. “I’d noticed. But I can see why, too. It’s hard to know exactly what you need to do and what the consequences are likely to be.” “Turns out the new software we’ve been looking at has an internal auditing process. Basically, I think we can work with the coaches to find out just how we can use our documentation to build the right ICD-10 codes, and actually try it out and see how far we are from perfection.” “And if you’re not quite perfect, you’ve got some time to work on it.” “Exactly. We’ll be able to see what practices we don’t yet have in place. We won’t be taking a shot in the dark and hoping we’re on the right track.” Mike sniffed. “Is that sauteed mushrooms I’m smelling?” “Yes. Mushroom ravioli tonight, with a fresh marinara sauce and garlic bread. Just a little good home cooking.” “Very good home cooking. Can I help?” “Come keep me company while I add a little squeeze of lemon.” Ben followed Carmen into the kitchen, where their son was already sitting at the table coloring. “I really feel like things are coming together,” he told his wife as he ruffled his son’s hair. “Just having a clear plan and a clear goal makes all the difference.” Carmen beamed.Ben held up his hands in mock protest. “Are you about to tell me some special way in which this reminds you of pizza?” “Not at all.” Carmen busied herself plating the ravioli and ladling on sauce. “I could however say that it’s like having a great recipe and setting out all the ingredients, measured and ready, before you begin to cook.” She added a slice of toasted garlic bread on each plate. “That’s the way you get a perfect outcome. It’s not that you don’t have work to do, but you have it all laid out clearly, so success is easier.” “I’ll take that,” Ben smiled. Will Dr. Ben’s new tech solution lead to the perfect outcome? Everything that we have published about ICD-10 can be found on our ICD-10 page.
Seeking Direction
By Kathleen Casbarro For ICD-10 transition, It’s Essential to Choose the Right Path Should Ben start practicing the new style of documentation long, or wait until he has to do it? “It’s great that you’re not experiencing pain any longer,” Ben told his last patient of the day, “but remember to come in for regular adjustments and keep it that way.” The young woman hefted her tote bag and stepped through the door. “I know I should, but somehow if I’m not having any pain I don’t make the time.” Ben commiserated. “Let’s go ahead and make your appointment now,” he suggested. “That way you’ll have that part done. Pam, can you help Sheila?” “Of course!” Pam took over with a warm smile.Ben understood what his patient meant. He had been trying all day to get used to the new clinical documentation he’d have to be using once the shift to ICD-10 codes took place. He had tried to note which side of the body each issue involved and to write notes with the level of specificity the new system would demand. It hadn’t been hard at first, but it had been a busy day. As patients mounted up and he and Pam skillfully navigated through a day filled with surprises as well as scheduled events, it got harder to take the time for the new style of documentation — and easier to fall back on the old system he found so comfortable. After all, it really wasn’t a problem right now if he skipped the notes on laterality or wrote something with less detail. The pain wouldn’t come up till later, so it was tempting to just wait till later to make the changes. In fact, Ben mused as he moved through his end-of-day routine, making the changes now was actually causing some pain. It was slowing him down a bit, distracting him from his key priorities, and probably irritating Pam and the rest of the team. Was it better to get a head start on it now, possibly lessening the pain of the transition in October but also perhaps lengthening the amount of time there’d be pain in the office? Or should he wait till closer to the time? In fact, maybe the best solution would be to do his documentation in the usual way and pass those on to Pam and the team, but then also to produce a second set of notes that would provide enough detail for the new set of codes? But then, Pam and the rest of the team wouldn’t benefit from the head start he would be getting. Ben suddenly realized he had been standing frozen in thought, one hand holding his car keys out in front of him and the other reaching for the door, for — well, an embarrassingly long time if anyone had happened to be looking. He shook his head and got back in motion. It was hard to know the right thing to do, that was all there was to it. Should Ben start practicing the new style of documentation, or wait until he has to do it? Visit our ICD-10 page to learn how ICD-10 diagnosis codes have been built into Genesis Chiropractic Software.
Note-Worthy
Staff and Office personnel have to work together to make transition easier. Can Ben’s self-improvement plans cause trouble for his staff? Pam looked up as Ben bustled into the office. “You’re energetic today!” “I’m feeling inspired,” smiled Ben. “We’ve made some smart changes in the practice, and we have more coming up, so I think I’m ready to tackle changes in documentation.” “I’m impressed,” said Pam, “but I hope you’re not going to make too many changes. I feel like I’ve had just about all the change I can stand.” Ben was surprised. “I don’t think this is going to be a problem, Pam. We know that the new ICD-10 codes that go into effect in October are going to require more detailed documentation. I’m just going to get a handle on the new requirements.” “I understand that,” Pam sniffed, “but I feel like I have just gotten to where I can completely understand your notes and pick out the important keywords for coding. If I have to get used to a whole new system… well, if it’s not essential, I’d rather we didn’t make any more changes, that’s all.” Ben took a seat. “You know there are a lot more codes in the ICD-10 system than with ICD-9 codes–” “Don’t I know it! Almost 70,000 total.” “And one of the reasons there are so many more is that the codes have to be a lot more specific. If you don’t have very specific clinical documentation, it’ll be easy to get the codes wrong.” Pam said nothing. “If we have too many coding errors, or inaccurate documentation, it becomes a compliance issue.” Pam frowned. “I see what you’re saying. We could face non-payment issues, or even be audited. That would be a lot more trouble than getting used to a new style in documentation.” “Exactly.” Ben stood and stretched. “Tell you what, I’ll work on my handwriting and punctuation at the same time.” Pam laughed — or, thought Ben, maybe it was a snort. Either way, he was ready to get on top of the new demands for documentation. It felt good to have a clear goal. Can Ben’s self-improvement plans cause trouble for his staff? See our ICD-10 page for more information and more blogs on the diagnosis codes.
