At this point, the majority of physical therapy clinics are using some type of software to document, schedule, and bill for patient treatment. Thanks to ever-increasing compliance regulations, paper had to go the way of the VHS, becoming nearly obsolete. When your practice switched from paper to software, it was a big change. The process took time and training, and there undoubtedly was a period of adjustment. Now, you’re faced with another switch: ICD-10. And just as you had to vet your software vendor when you ditched paper, you’ve got to scrutinize your system again to ensure it can handle this next big change. So, how do you ensure your physical therapy software—that is, your EMR or practice management system—is ICD-10 ready?
It knows how to be specific.
ICD-10 has more than five times as many codes as ICD-9, and that’s because the new code set requires medical professionals to be incredibly specific about their patient diagnoses. That, in turn, forces practitioners to do away with their reliance on unspecified codes. According to this HIMSS page, “With the expansion of diagnosis codes comes a greater level of detail; therefore a greater level of detail will be required in the encounter documentation in order to assign an appropriate diagnosis code.” That’s right; detailed diagnoses beget detailed documentation. As this article asks, “How is a biller or coder supposed to select and/or verify a diagnosis code if the supporting documentation isn’t detailed enough to inform that choice?” How specific you are in your documentation is up to you, but wouldn’t it be great if your documentation platform helped you along? Thus, when it comes to the ICD-10 switch, you’ll want to make sure that your software:
- Has compliance regulations built into the documentation process to ensure your SOAP notes are always up to snuff.
- Provides ample opportunities within the note to demonstrate medical necessity.
It provides a smart code selector.
Let’s assume your current physical therapy software has a built-in code selector. If it doesn’t, jump ship immediately; if you don’t know, stop what you’re doing and call to confirm. Of course, you don’t want just any built-in code selector. Your current software may have all the codes locked and loaded; you may even be able to search for codes by diagnosis or anatomic site. But ultimately, it’s again about specificity—and if the code selector doesn’t take that into account, then stick a fork in your software, because it’s done. Here’s why: “...let’s say you’re searching for a code to express the diagnosis of patellar tendinitis,” explains Brooke Andrus in this article. “The code M76.50 (Patellar tendinitis, unspecified knee) might appear at the top of your search results, but it doesn’t account for one very important diagnostic detail: laterality.” If your software platform has a smart code picker, though, it’ll show that more specific codes exist. You can then drill down to the correct laterality, thereby decreasing your risk of a claim denial for lack of specificity. (FYI, WebPT has a smart code picker that does all this, plus allows you to build a “favorites” list of codes.)
Now, just because the code picker is smart, doesn’t mean it should think for you. When it comes to ICD-10, complete automation of code selection and code conversion is impossible. Thus, as this post explains, ...“if you’re relying on a software that proclaims it can ‘handle’ ICD-10 for you and produce ‘one-to-one matches’ without any effort on your part, you should exercise extreme caution.”
It allows you to test now.
We’re a little more than a month out from the October 1 switch date, so we’re running out of prep time. That’s why it’s imperative that your physical therapy software is allowing you time now to prepare. As this article explains, “If your first time using your EMR’s ICD-10 functionality is October 1, 2015, then you could be fighting an uphill battle fraught with frustration, claims backup, and workflow disruption.” Thus, you should verify immediately that your software has its ICD-10 solution available now. That way, you and your staff can train, run internal testing programs, and participate in any last-minute external testing opportunities. (Another FYI: WebPT’s ICD-10 tool is live and ready for your practice activities.)
It can answer all your questions.
Your physical therapy software company should be more than ready—and available—to answer all your ICD-10 questions. (And it should provide such help free of charge.) The vendor is your business partner, after all, and if it’s offering up ICD-10 tools, it better have the resources—and the know-how—to back up that functionality. Beyond inquiring about general preparedness and learning opportunities, you also should ask your software vendor the following questions:
- Is your software compatible with the new code set? This seems like a no-brainer, but if you can’t currently access a tool—and you haven’t received any kind of messaging around the vendor’s ICD-10 functionality—then it’s time to nail down all the details, especially the date when it will be available to use.
- Will both ICD-9 and ICD-10 codes be available after October 1? All HIPAA-covered entities must switch to ICD-10, but what about those not covered under HIPAA? Select payers like auto insurance and worker’s compensation may still use ICD-9 codes after October 1. Make sure your physical therapy software can handle that.
- Will the ICD-10 system require a system update? If so, how much will that update cost me? We’re already seeing this happen, and unfortunately, it’s more common than you think: software vendors charging their customers to upgrade to ICD-10 functionality. Don’t let any software company do that to you. As this blog post explains, “ICD-10 adoption is mandatory, so your software vendor needs to change no matter what; otherwise, it’ll go out of business. In my book, your practice shouldn’t have to foot the bill for a healthcare change that your vendor has to make.” If your vendor is trying to charge up for an ICD-10 upgrade, give that software the boot—and fast.
You’ve already ditched paper documentation. Now, it’s time to leave ICD-9 in the dust (except for those payers who will still require those codes after October 1). When you switched to electronic documentation, your physical therapy software provided—or should have provided—a a lot of hand-holding. The same should be the case with ICD-10. I cannot stress this enough: your software vendor is your business partner. If you’re not receiving the support, guidance, know-how, and functionality you need and deserve, then it’s time to shop around.