GeBBS Healthcare Blog

Everyone in healthcare, who deals with coding, is keenly aware of the October 2014 deadline that is looming over the industry. Some are facing it head-on; others seem to be ignoring it, hoping it will just go away. No matter where you stand on the timeline or on your journey toward ICD-10 preparedness, here are 5 practical ideas that can help you cope with this challenge.

How much emergency cash should you have in reserve to deal with ICD-10? Most healthcare providers can expect disruptions, some of them very serious, in their payments during the transition to ICD-10. Even if you have made preparations for this event, it is likely your revenue stream will take some kind of hit.

Seldom has any mandate or compliance regulation had the potential to disrupt, so severely, the revenue stream of almost every healthcare provider. The transition to ICD-10 is going to require one of the most intense and longest learning curves in the history of U.S. healthcare. As everyone is aware, proper coding of the care delivered is critical to your reimbursements.  Moving from ICD-9 to ICD-10 is going to be a giant leap -- not a baby step.

It is highly unlikely you will be hit by a sea lion – new ICD-10 code W5612XA, but it’s a sure thing your revenue stream will take a devastating blow if you are not fully prepared for the transition to the new ICD-10 coding set. The code mentioned in the previous sentence is just one example of the seemingly ludicrous granularity of the new ICD-10 codes. This increased specificity, which offers well over 70,000 codes, will create an overwhelming potential for errors in your coding workflow. Even your most experienced coders are going to find this transition challenging.

Key Questions to Ask

The transition to ICD-10 is going to be a monumental task.  In our opinion, almost no healthcare organization will be able to reach ICD-10 compliance without help from healthcare technology vendors.

The Centers for Medicare and Medicaid Services (CMS) sent out a list of questions that can help healthcare organizations assess vendor's readiness capabilities:

• Do your current vendor contracts cover your practice's ICD-10-related needs?

• What is the vendor's timeline for the ICD-10 transition?

• Will your vendor install products well before the October 1, 2014, deadline, so you can begin testing them in 2013?

• Has your vendor scheduled with you to test your system with your trading partners?

• Will all your vendor's current products and applications be updated for ICD-10?

• Has your vendor scheduled training for your staff on the ICD-10 system updates?

• Do your vendor’s products give you the ability to search for codes by the ICD-10 alphabetic and tabular indexes? By clinical concept?'

• Will your vendor’s product allow for coding in both ICD-9 and ICD-10 to accommodate transactions with dates of service before October 1, 2014, and transactions with dates of service after October 1, 2014?

Additionally, make sure you have someone in-house to manage your side of the ICD-10 transition.  Your vendor will be a key partner, but you need to ensure your facility is doing everything it can to support your vendor in meeting your transition needs.

As a result of the answers to the above questions, if you discover your present vendor will not be able to meet your transition needs, the following questions will help in your search for a potential, new vendor; they are slightly different:

• Will your products be ready for the ICD-10 compliance date?

• How does your product simplify my organization's transition to ICD-10?

• How does the functionality offered by your system compare with my current system?

• Does your implementation require a complete system conversion?

• Based on what I already have in place, how much will it cost to convert to your system?

• What are the costs of maintenance for your product?

• Will there be training on your products?

-- Does training cost extra?

-- How much time will training take?

• What other healthcare organizations are currently using your products/services?

Hopefully these questions will help you assess the readiness of your present vendor and/or help you in your search for a new ICD-10 transition partner.

In today’s healthcare economic climate, the majority of healthcare providers are acutely interested in optimizing their revenue cycle performance. The first aspect to be considered is -- where is the best place to start? It is also important to remember that revenue cycle performance improvement is a journey, not a destination.
 

ENGLEWOOD CLIFFS, NJ, May 08, 2013 -- GeBBS Healthcare Solutions, Inc., an industry leader in healthcare revenue cycle management outsourcing solutions, will be demonstrating its state-of-the-art coding platform, iCode, at the Radiology Business Management Association (RBMA) 2013 Radiology Summit, May 19-22 in Colorado Springs, Colorado.

On October 1^st, 2014, the official use of and mandatory transition into ICD-10 in the United States will commence. In addition, it will be split into two systems: ICD-10-Clinical Modifications (CM) (a system that uses unique alphanumeric category classifications for the first time, includes more than 68,000 diagnostic codes, and has twice as many categories as ICD-9-CM), and ICD-10 procedure coding system (PCS) (a system for inpatient hospital procedure coding).

According to a recent healthcare technology research study, U.S. Revenue Cycle Management by HIMSS, focused on the revenue cycle management (RCM) marketplace, positive changes are predicted in the attitudes of CEOs, CFOs and IT directors toward the efficacy of RCM to improve a healthcare facility’s financial operation.

The study included nearly 400 participants -- CEOs, CFOs and IT directors -- representing 360 U.S. hospital organizations of various sizes with the objective of assessing how the HITECH Act’s focus on stimulating the adoption of Electronic Health Records (EHR) and Health Information Exchange (HIE) solutions combined with the delay in the ICD-10 compliance deadline was impacting the RCM marketplace.

The study found that 21 % of participants said they were planning to replace or enhance core RCM capabilities in the next 24 months, and for hospitals with more than 400 beds, that number increased to 36 %. 53 % of the respondents said they plan to upgrade their core RCM due to healthcare financial regulatory changes, with that number increasing to 68 % for the hospitals with more than 400 beds.