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Preparing for ICD-10

As the ICD-10 conversion date of October 1, 2015 approaches, we wanted to send an update regarding preparations for the transition. Below are updates we thought were important to share with our clients.

Allscripts Vision Training

Alta Partners will be providing its clients with Allscripts Vision training during the second and third quarters of this year. Training will be focused on how to enter ICD-10 codes into the system and will be conducted by Alta Partners' team members Lynn Bolin, CMPE and Andrea Devlin, CPC. Clients will be contacted to schedule training sessions. Alta Partners will continue to update you with the steps being taken to prepare for the ICD-10 transition.

About Our Trainers
Lynn Bolin, CMPE is Alta Partners' Director of EHR and Trainer. During her career she has been responsible for the implementation, optimization and utilization of Electronic Health Records (EHR) for 75 medical providers in 38 physician practices from 10 healthcare systems. Lynn has had the opportunity to work with nine different EHR software platforms (NextGen, Epic, Caretracker, Aprima, eMD, Allscripts MyWay, Allscripts Professional, Vista, eClinicalworks) for ambulatory provider practices. Lynn is an experienced professional with a unique insight into the needs and challenges facing providers, physician practices and healthcare systems. She holds a certification of Certified Medical Practice Executive through the American College of Medical Practice Executives and MGMA, and a certification of Clinician/Practitioner HIT Consulting through Cuyahoga Community College.

Andrea Devlin is the newest member to Alta Partners' team of professionals. She is a Certified Professional Coder (CPC) certified in ICD-10 coding (both general and OB/GYN) and is currently working on her Certified Professional Medical Auditor certification. Andrea has over twenty years of experience in healthcare, working within the Northeast Ohio healthcare community in various capacities. She began her career as a medical billing specialist. Over the years Andrea advanced to hold various positions including Physician Referral Specialist, Reimbursement Specialist, and Accounts Receivable Supervisor. Before joining Alta Partners, Andrea was working as a billing manager at a local OB/GYN practice.

Allscripts Payerpath ICD-10 Testing

Allscripts Payerpath participated in the first ICD-10 end-to-end testing session provided by CMS during the last week of January. The results so far have been extremely positive. All ICD-10 test claims were submitted and accepted, error-free, into the payer's system for adjudication. Over the next two weeks, Payerpath and testers will be receiving and reviewing the 835 remittances on these same test claims. Once the analysis is complete, Allscripts will send further communications regarding the results.

Preparing Your Practice for the ICD-10 Transition

October 1, 2015 is the compliance date for implementing ICD-10; claims for services provided on or after this date must use ICD-10-CM for diagnoses. It is important that your practice is ready for the transition.

An essential step is training - identifying staff and providers who will require training and ensuring that they receive appropriate level of training for their role. This includes both ICD-10 coding and clinical documentation improvement (CDI). Clinical documentation, in order to support the new codes, will need to have a higher level of specificity and granularity than with ICD-9. Appropriate documentation will be key in ensuring optimal reimbursement, meeting regulatory and reporting requirements, and accurately reflecting the care provided.

It is also important to assess and prepare for the potential impact the transition may have on other areas of your practice. Productivity and work flow may initially be affected due to the new documentation requirements. Policies/procedures may need to be revised or developed. Coding accuracy may also be impacted by the transition to ICD-10. Assessing the potential effects on your practice can help you to determine what steps you can take now to reduce the impact of the conversion.

The Centers for Medicare and Medicaid (CMS) and The American Health Information Management Association (AHIMA) both have resources available to aid providers and health care entities in the transition to ICD-10. CMS's website, Road to 10, helps providers to build an action plan based on their practice's size and specialty, provides reference materials and templates, and has a webcast series covering the various aspects of the transition. Click here to visit the CMS website. The AHIMA ICD-10 website offers information on the new code set, documentation tips and webinar, an implementation toolkit and preparation checklist. Click here to visit AHIMA's website.

GAO Issues Report on CMS Preparation for ICD-10

In a report issued January 28, 2015, the Government Accountability Office (GAO) found that CMS (Centers for Medicare and Medicaid Services) is on track in its preparations for the ICD-10 transition. The GAO evaluated CMS's activities to support covered entities in the transition from ICD-9 to ICD-10. The report mentioned several positive actions CMS has taken to aid in the transition, including the following:

  • Modified Medicare systems and policies, including ICD-10 related changes to the Medicare fee-for-services (FFS) claims processing systems

  • Developed educational materials and promoted awareness of these materials

  • Conducted outreach to prepare entities for the transition, including in-person training

  • Held stakeholder collaboration meetings to monitor entity and vendor readiness

  • Provided technical assistance to Medicaid agencies and monitored their readiness for the transition

  • Scheduled end-to-end testing with 2,550 organizations during three weeks in 2015 (January, April, and July)

While CMS has taken many positive steps, there still may be additional actions to be taken based on the results of its ongoing external testing activities. The full GAO report can be accessed here.