ICD-10 for Optimists

With a new, clean calendar comes the intimidating task of preparing your practice, your providers and your billing staff for the advent of ICD-10 coding. October 1st, 2015 may be an imposing, if not frightening, deadline for practice managers concerned about their Medicare payments. Who isn’t? Even though there are revenues at stake and many hours of preparation ahead, the ICD-10 rollout offers some opportunities for positive thinking.

Optimists will see that ICD-10 offers some framework for better healthcare.

“With ICD-10, physicians will have access to better data in hopes of improving patient care in the future,” points out Michelle Saez, MBA, CPC. Because the new system breaks down many ICD-9 codes into large groups of more detailed ICD-10 codes, they offer a benefit to patients. “ICD-10 will allow patients to have a more detailed diagnosis history which can essentially help better coordinate their care over time,” according to Saez. You’re in the right specialty for 2015! If getting used to these detailed groups of codes in the new system scares you, take heart in the fact that you work in Nephrology. Some commonly used codes for Nephrology care, unlike those for many specialties, are already quite specific and will actually only convert from a single ICD-9 to a single ICD-10 code. For example, for End Stage Renal Disease, ICD-9 code 585.6 is changing to ICD-10 code N18.6; Chronic Kidney Disease, Stage III is changing from 585.3 to N18.3. There are many more examples. Another benefit of the change this year is that in the new system, numerous non-compliance codes legally protect physicians by allowing physicians to document when patients are not completing their treatment or taking their medications as directed.

Physicians will enjoy reduced denials thanks to more specific documentation. Granted, in the early stages of the ICD-10 system, denials may increase as staff members get up to speed. However, Saez assures practices that the investment in ICD-10 readiness will pay off. In fact, those practices using an up-to-date EHR system, as required by Medicare guidelines, will benefit when the EHR actually populates diagnosis codes correctly for a typed diagnosis. “ICD-10 preparation is imperative for practices to continue to be relevant in the future of healthcare,” Saez states. So, look on the bright side and continue to invest in ICD-10 readiness. Early communication with your billing staff or outside billing company is a great start. If you are in need of coding and billing support, contact Tower Physician Solutions to learn how we may help. Michelle Saez is a consultant with Tower Physician Solutions and Revenue Cycle Manager for Nephrology Associates of Northern Illinois and Indiana. She holds an MBA and is a Certified Professional Coder.

Tower Physician Solutions is a management services organization offering practice management services to small nephrology practices nationwide, including coding, billing, accounting, technology support, HR support and strategy consultation.
E-mail info@towerps.com or call 630-243-5731.