Importance of Testing ICD-10

“ICD-10 is coming. ICD-10 is coming.” You might be tempted to turn away, go back to work, and ignore this Paul Revere-style warning. But that would be unwise. Sure, October 1, 2015, might seem far, far away, but we all know that time flies, and this ICD-10 implementation deadline will be here before we know it. So let’s put a big X on the calendar, and begin our countdown to preparedness. Today, we’re talking about the importance of ICD-10 testing.

ICD-9 vs. ICD-10

Yes, both ICD-9 and ICD-10 consist of diagnostic and procedural codes, but ICD-10 is significantly more complex. In fact, there are almost five times as many ICD-10 diagnostic codes (68,000) as there are ICD-9 ones (14,000). Plus, the new codes are alphanumeric and can contain seven characters. (For comparison, the old ones are mostly numeric and have just three to five digits.) Want an example of the new code complexity? Check out this one.

Testing

 In her article titled Roadmap to ICD-10, Brooke Andrus wrote about Advanced MD’s three-part test plan:

  1. “Test that your office staff can competently work with the [new codes and] redesigned workflow.  
  2. “Test each redesigned process.
  3. “Test integration with partners.”

The first two are examples of internal testing; the third is external. They’re both equally important, and we’ll go into greater detail about each in just a moment. But before we do, consider your internal coding processes. Here are a few good questions to get the ball rolling:

  • Who in your clinic touches your codes? Your clinicians, billers, front-office staff, directors?
  • What ICD-9 codes do you use most frequently? What are their ICD-10 equivalents?
  • Where and how does your staff locate correct codes currently?
  • Will your processes still make sense after the codes change?

After you have the answers and fully understand the ways in which your clinic codes today, you can begin internal ICD-10 testing.

Internal Testing

If you’re using an EMR that’s building you an ICD-10 solution (like WebPT is), transitioning to ICD-10 will be a whole lot easier. But you won’t be able to start testing within the system until the solution is ready. And that’s okay, because a custom solution will be worth the wait. In the meantime, you can practice with the new codes manually and become really familiar with the ones you’ll be using most often. If you’re not using an EMR like WebPT, you’ll want to start dual coding (i.e., recording the ICD-10 equivalent to the ICD-9 codes you submit) soon because you won’t have the extra help come October 1. Either way, though, working with ICD-10 early will help you and your staff get comfortable with the new code structure and check for any snags in your processes. If you identify challenges, which you most likely will, you’ll have plenty of time to redesign your processes, implement the changes, and test them again. Remember, though, CMS and other payers will not process ICD-10 codes prior to October 1, 2015, and most won’t process ICD-9 codes after, so timing is everything.

By the end of your internal testing phase, you should feel confident enough to check numbers one and two above off your testing plan. And that means your staff and your processes are in tip-top ICD-10 transition shape.

Feeling overwhelmed before you’ve even begun? Don’t, because Mark Lott, CEO of Lott QA Group and coordinator for the HIMSS WEDI National Pilot Program, has some good news. The author of a Healthcare IT article, titled “Neglect to Test for ICD-10 at Your Peril,” quotes Lotts 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." That should take a lot of the pressure off.

External Testing

Once everyone in your clinic is an ICD-10 rockstar, you can begin external testing. That is, ensuring that every one of your external partners is ready and able to process the new codes.

According to this EHR Intelligence article, to survive the ICD-10 transition, “you have to be flexible, proactive, and prepared,” especially when you begin testing with external partners. Part of being prepared and proactive includes following this piece of advice from CMS: ensure that testing includes sample cases that span every relevant code category and make a point to “consider common errors, such as mistaking a zero for [the letter] O, to figure out what happens when claims don’t go through.”

The same article also recommends that practice owners and directors take a “multi-phase approach to testing to cover different testing objectives.” In other words, set testing goals and make sure they’re specific, measurable, attainable, timely, and, of course, relevant (SMART). Then, communicate your goals and your timelines to your staff and your partners. Finally, follow through. Just remember to be flexible “and build in extra time in your implementation plan to cope with surprises and delays.”

By the end of your external testing phase (i.e., September 30, 2014), you’ll be able to check number three above off your testing plan. And that means your partners are ICD-10 rockstars, too.

 

How are you feeling about the ICD-10 transition? What steps has your clinic taken to begin ICD-10 testing? Tell us in the comments below.

WebPT + Billing Software - Regular BannerWebPT + Billing Software - Small Banner
  • articleOct 15, 2013 | 3 min. read

    ICD-10 Checklist for Your Practice

    We’ve given you a lot of ICD-10 info to process this month. And in case you haven’t noticed, our main mantra has been “prepare, prepare, prepare.” Because like Confucius, we firmly believe that “success depends upon previous preparation, and without such preparation there is sure to be failure.” (And considering he’s the man behind one of the most influential movements in Asian history—not to mention the author of all five Chinese Classics—we’re thinking this Confucius guy gives …

  • The History of ICD-10 Image

    articleOct 9, 2013 | 3 min. read

    The History of ICD-10

    As we’ve stated in previous blog posts, the US will transition to ICD-10 codes on October 1, 2015—to some of you, that might seem like a quickly approaching date. Others might be wondering, “What’s the rush?” Know that it only seems hurried now because of pesky procrastination. To truly understand this, we must delve into the history of ICD-10. In the beginning... The World Health Organization (WHO), the public health sector of the United Nations, which focuses …

  • A Farewell Ode to ICD-9 Image

    articleSep 30, 2015 | 2 min. read

    A Farewell Ode to ICD-9

    As the hours count down It’s hard to believe That we’ve finally made it To ICD-10 Eve Our journey to get here Hasn’t been without strife As the US has clung To ICD-9 for dear life Letting go can be hard And change can be tough But in the modern medical world ICD-9 just isn’t enough Unlike a fine wine That gets better with time ICD-9 has aged poorly— It’s way past its prime Sure, we’ll always …

  • How Will ICD-10 Affect Direct Access? (And Other Billing Questions) Image

    articleJul 16, 2015 | 6 min. read

    How Will ICD-10 Affect Direct Access? (And Other Billing Questions)

    In healthcare sectors across the globe, ICD-10 is hardly  a new concept . But in the US, we’ve been hesitant to adopt the updated system since its inception more than 30 years ago. In just a few short months, though, that’s all going to change. If you’ve been watching the news, reading  the WebPT Blog , or talking with your colleagues, you’ve probably gotten the sense that the  ICD-10 delay , debates, and—for some—dread are about to …

  • ICD-10 FAQ Part 4 Image

    articleNov 3, 2015 | 5 min. read

    ICD-10 FAQ Part 4

    Like the many Land Before Time sequels, the versions of our ICD-10 FAQ keep on-a-comin’. But—unlike those beloved dinosaur tales—I don’t anticipate 12 more versions (plus a TV series) will be necessary to cover what’s to come with ICD-10. Still, the questions continue to roll in—albeit a bit slower than they did a couple of months ago. However, most of the inquiries we’ve received in recent weeks have been super specific. That’s why, our most recent webinar—the …

  • Compliance Expert Tom Ambury Talks ICD-10 Image

    articleApr 10, 2014 | 3 min. read

    Compliance Expert Tom Ambury Talks ICD-10

    Everyone has been gearing up in preparation of the October 1, 2014, ICD-10 implementation deadline. (Even CMS changed their claim form requirements: beginning on April 1, 2014, if you submit paper claims, you must use CMS1500 version 2/12 instead of version 8/05.) No one thought there would be another delay—that is, until Thursday, March 27, when the House of Representatives passed HR 4302, a bill that contained a provision to delay the implementation and extend the therapy …

  • ICD-10 Open Forum Image

    webinarOct 5, 2015

    ICD-10 Open Forum

    On October 1, the US officially said RIP to ICD-9 and brought ICD-10 to life. For some of you, the transition might’ve been all sugar and spice—a real treat. But for many others, the switch to the new code set might’ve left you feeling overwhelmed, tricked, or even a bit scared. At the very least, you might be haunted by some lingering questions. That’s where we can help. We’ve brewed a cauldron filled to the brim with …

  • Your Roadmap to ICD-10 Image

    articleOct 10, 2013 | 5 min. read

    Your Roadmap to ICD-10

    By now you’ve already—hopefully—heard the news about the big ICD-10 transition that’s going down on October 1, 2015. But, if you’re like most US healthcare providers—about 75%, according to this article —you haven’t exactly stuck to the suggested preparatory timelines that CMS released a while back. We get it; you’re busy, and the last thing you have time for is sitting down and mapping out a plan of action for your clinic’s transition to ICD-10. But putting …

  • Costly ICD-10 Traps and How to Avoid Them Image

    articleAug 26, 2015 | 5 min. read

    Costly ICD-10 Traps and How to Avoid Them

    Imagine you’re playing a game . More specifically: an ICD-10 Rube Goldberg-style game . To win, you have to scurry through a series of stages without getting caught in costly traps. But what happens when you find yourself at the mercy of the swiftly-turning plastic crank? Before you know it, the cage has lowered and you’re out of the game —forever separated from your cheddar. Okay, so ICD-10 isn’t a game of zany action on a crazy …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.