ICD-10 testers recommend certified coders, lighter loads for October

The advice from those who have already tried coding with ICD-10? Hire a certified coder if you don’t have one on staff already.

“If a physician office doesn’t have a certified coder, it should,” according to Penny Osmon Bahr, director of Avastone Health Solutions, who took part in the final International Classification of Disease, tenth revision, “end-to-end” test conducted by the Centers for Medicare & Medicaid in July. “That’s just plain and simple.”

Ms. Osmon Bahr described coding as “the pulse point of how data are really consumed,” whether via ICD-10 or part of value-based contracting, research on patient outcomes, or incentives being driven by the CMS. “It takes coders to ensure that the data that is going out truly represents your patient population and the patients that you are treating.”

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Some physician practices “haven’t invested in education for staff to become knowledgeable in coding or certified in coding. That could be a struggle as the world continues to evolve.”

Another bit of advice: Scale back on the number of patient visits you book in October. That will give extra time to learn and incorporate ICD-10 into work flows.

“One of the things that we’ve encouraged our physicians to do is they need to lighten their schedules in October to prepare for ICD-10 to make sure they are completing the documentation that’s needed and coding with the current codes,” Lori Albano, manager of EDI development and support with practice management and EHR software vendor Nextgen Healthcare of Atlanta. “So maybe the first 2 weeks they lighten [appointments] by 20%” and then set up a specific schedule to ramp back up to full capacity.

Ms. Albano also recommended a focused approach to learning new codes to help avoid being overwhelmed.

“Take the top 50-100 ICD-9 codes that you currently use and become familiar with those ICD-10 codes and the documentation required to support them,” she said. “Start documenting on that level now.”

Ms. Osmon Bahr also stressed thorough documentation.

“You always want to tell the most specific story about your patient that you can,” she said, based on the greater number and specificity of the ICD-10 code set.

Ms. Osmon Bahr and Ms. Albano both spoke positively of the experience of testing and said that CMS appears ready to make the transition. The agency announced on Aug. 28 that its final round of end-to-end testing found no new issues and that no CMS front-end issues led to claims rejections. Previous issues in prior test rounds have been resolved, the agency noted.

gtwachtman@frontlinemedcom.com