What does "ready" mean in regards to ICD-10 and you, the physician?
If you are a physician, it means knowing the correct new codes to use that reference your diagnosis. ICD-10 is extremely more specific about each diag, whereas in ICD-9 the codes are more generalized.
What are the ramifications of not being ready for ICD-10?
The short answer is: Claim Denied. The best case scenario: it will take more time and effort on your part to provide the additional documentation that the insurance companies are going to require in order to adequately support your claim.
And, since your in house or outsourced medical billing company cannot legally change the codes on your diagnosis, you are looking at a delay of payment that will be measured in months, rather than weeks, by the time it all gets sorted out. Needless to say, this will have a noticeable impact on your revenue cycle.
Follow these few easy steps to help with a smooth transition into ICD-10.
- Don't wait. Set the time aside now to study and become well versed in your ICD-10 codes.
- Have enough cash set aside to cover a minimum of three month's total operating expenses, including your own income, to carry you through the transition period. You will make mistakes, and the insurance carriers are looking to avoid paying claims. There is a better than average chance that your revenue stream will suffer during this time.
- Make sure that your EMR software has been updated with the new codes.
- If you use an in house billing person, make sure that he/she is ready. Don't wait until the last minute. If you employ a medical billing company, ascertain that they are, in fact, ready for the trasition. This includes their software, if applicable, not just their training in the new codes. You should not assume that your medical billing company is ready to go!
- Get in touch with your Clearinghouse to ensure that they, too, are ICD-10 ready.
There is not much time left, but if you handle all the contingencies now, your transition to ICD-10 should be smooth and effortless.