Medical Coding Experience — Change is Coming

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It finally hit me last week while reviewing my Allscripts™ Practice Manager “ICD-10-CM Early Adopter Draft” for the “5th time” that months are passing quickly and that “now” is the time to officially prepare my billing and coding office for the major changes about to come.

Since the introduction of ICD-10, I have kept my staff busy with slide presentations and hands-on training of code sets. We access provider medical records and point out the poor quality of documentation and improper use of ICD-9-CM codes. We then take the same documents and code them according to ICD-10-CM requirements and add recommendations if needed.

Urgency has permeated the air and as responsible medical coders we know we must now aggressively move forward and begin teaching our doctors the importance of documentation and the understanding of specificity in the level of their code choices. This is no easy task. True, there are always health care clinicians who jump into the learning process, but most prefer to avoid change and hope for the best.

Although medical practices might hesitate in paying extra money for coders who are proficient in ICD-10, it is a serious enough issue that will financially impact a medical office if present staff lacks coding experience or ICD-10 training.

Planning is key so begin by finding a leader who is up for the challenge and can persuade all personnel to follow him or her. For employees who are less than par and unmotivated, this may be the time to replace them with personnel who will enhance production and keep coding and documentation ethical as well as reimbursable.

Medical Coding Experience – Change is Coming

Educating your ICD-10-CM team will allow them to visually see how much is understood at the ICD-9-CM level (particularly The Guidelines) and what is needed to proceed. Visit www., www.aapc.com, www.supercoder.com, as well as insurance carrier websites like Blue Cross Blue Shield and Medicare offer guidelines for preparation.

The process can be overwhelming so by taking small steps through the transition, your practice will be ensured that all areas are covered.

• As mentioned earlier, review medical documentation and make recommendations.
• Plan a budget. Will you need new hardware and software? How much will it cost you? Will you need training classes? The answer to that is definitely yes! When considering your budget, be prepared for cash flow interruptions. Even if your office prepares properly, you will be communicating with vendors, clearing houses, labs, other medical offices, facilities and more. Somewhere in this web of technological networking, there will be a glitch or two. Vigilance to your claim submission printouts from clearinghouses as well insurance payers is vital.
• Develop a timeline NOW if you haven’t already.
• Speak with all entities directly involved in your successful transition. You may be ready but are they?
• Assess coding staff’s expertise in anatomy and pathophysiology, medical terminology, pharmacology and clinical knowledge. If there are weak areas, start the training process now. CodingCertification.org and AAPC offer online medical coding courses to prepare your staff.

Without question, the time is NOW. Cross training, ICD-10-CM coding training, IT involvement are all key in making the biggest change to hit health care.

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