ICD-10-CM Medical Billing & Coding Readiness

     ICD-10-CM is effective on October 1, 2014.  How would you rate the readiness of your medical staff to be able to document to the extraordinary specificity demanded by the new Coding Schema?  The implementation is not just an event in time; it is an ongoing change to the culture of Clinical Documentation and coding.

     In the past, a Coder could ask a Physician what he really meant in the documentation and at some point in time it might be explained.  That is no longer the case.  Neither the Physician/Clinician nor the Coder will have the time to “chase down” the answers to the questions about diagnosis or procedure.  The difference between where we have been and where we will be on October 1, 2014 is not just an additional 52,000 codes but an entirely new reasoning process and one requiring attention to incredible specificity.

     In our work over the last 26 years we have worked with most of the academic medical centers, large physician groups and faculty practices on each iteration of coding.  In our estimation, this is by far the most difficult.  It is the most difficult because the gap between the Clinical language used by the Physicians traditionally cannot be bridged simply; it is much more complex and therefore greater effort must go into the initial effort of getting the specificity correct.

     In our experience specificity has been a problem shared by both the Clinicians and the Coders.  In order to meet this challenge, HSMN has developed a program which we call “Start 10”.  It is an interactive program that works with the entire Revenue Cycle Continuum of processes and people.  We take current cases and concurrent ones to evaluate the performance by each Revenue Cycle participant.  We deconstruct the case and then reconstruct it in ICD-10.  The case is then presented and discussed with each group within the revenue cycle.

     The physicians in each discipline will have several cases “Deconstructed” and then “Reconstructed”.  These will be presented at grand rounds.  We will be searching for Champions who really get it and can help others.  We will do the same for Coders, Billers, and Schedulers.  The “Culture” of ICD-10 must start to be felt early on.  It will be hardest on the clinical staff because they have never been asked to be this specific.

     We urge you to look at the entire continuum of the Revenue Cycle as you prepare for October 1, 2014.   Of course we would welcome your call or email to discuss a program to meet your needs.  We must add that it is a program which we model for your staff and which then is transferred to your staff to carry on.

     Call us 866-908-4226 or email us info@hsmn.com for a consultation.  HSMN has been around much longer than many of the firms proposing to do ICD-10 readiness assessments.