ICD-10 is coming—as of now, it’s slated for 2015. But just because it’s been delayed doesn’t mean you should delay your testing plans. Today, we’ll discuss how to test ICD-10 internally (and tomorrow, we’ll tackle testing externally).
- Your staff can competently use the new codes.
- Each redesigned process or workflow actually works.
But before you begin, you should know:
- Who in your clinic touches your codes (billers, front office personnel, and clinical staff, for example).
- What ICD-9 codes you use most frequently and their ICD-10 equivalents.
- Where and how your staff locates correct ICD-9 codes and where and how they’ll locate ICD-10 ones.
- If your coding processes will still make sense after the codes change.
Once you’ve got your answers, it’s time to begin testing. While the American Medical Association recommends allocating at least two to three months for internal testing, we believe the more time you commit to this the better off you’ll be come the mandatory transition deadline. After all, practice makes perfect. With this in mind, let’s go into more detail on items number one and two above:
Test that your staff can competently use the new codes.
There are plenty of ways to do this, but one of the most effective methods is to implement dual coding. That is, everyone who touches diagnostic codes in your clinic should report—or verify—both the ICD-9 code and the correct ICD-10 equivalent for every patient who comes into your clinic over the next 16 months. Now, some payers may not accept ICD-10 codes before the transition deadline, so be sure to confirm that submitting both codes won’t create a problem. If some of your payers would prefer that you only submit ICD-9, that’s perfectly fine. Just make a note of the correct ICD-10 code in the patient’s medical record. The lesson is the same either way. Practice dual coding for the next year and a half and, come the transition deadline, you can be sure that your staff will be able to competently—make that expertly—use the new codes.
Feeling overwhelmed at the mere thought of tackling 68,000 ICD-10 codes? Don’t. The author of this Healthcare IT article quotes Mark Lott, CEO of Lott QA Group and coordinator for the HIMSS WEDI National Pilot Program, as saying: “You don’t need to know all the ICD-10 codes well, you just need to know the diagnoses codes for your specialty well.” Phew—that’s a load off.
Test that each redesigned process or workflow actually works.
Depending on how you diagnostically code today, you may need to review and tweak your current processes. For example, once ICD-10 is official, it’s imperative that physical therapists generate an ICD-10 diagnostic code that addresses the exact patient condition they’re treating as opposed to merely carrying over the referring physician’s code. The sooner you examine your old processes, identify areas for improvement, and outline new ones, the sooner you can begin testing them—after all, a lot can change when processes move from theory into actual practice.
According to the American Medical Association, “Internal testing is done within an organization to determine if the programming or software changes for the ICD-10 code set have been installed correctly and the systems are functioning properly.” However, if you work exclusively with a billing service or clearinghouse that submits the necessary data on your behalf, your internal workflow testing need only ensure that your internal processes are ready and able to get them the data they need.
Have you started ICD-10 testing yet? What advice do you have for other rehab therapists? Share your thoughts in the comments section below.