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Avoid Major Cash Flow Disruption and Get Ready for ICD-10

Oct 30, 2013 11:25AM ● By MED Editor

Family Physician Kevin Bjordahl, MD, of Avera Medical Group Milbank checks on a young patient.

Quick trivia: What do Myanmar, Liberia and the U.S. have in common?  

Answer: We’re the only countries that still haven’t adopted the metric system.

As further evidence of our stubbornness as a nation, we have been snubbing our nose at the 

Heidi Babb

rest of the world regarding disease classification by remaining one of the last holdouts still using ICD-9. But on October 1, 2014, we conceded one of these points by adopting the ICD-10 system and joined the rest of the industrialized world. If you’re like me, my initial instinct would be to “file” away a reminder in the next September file (which is right next to my “order Chicago Cubs World Series tickets” file) and go about my day.

Unfortunately, this transition will require more attention if you want to avoid a severe shock to your cash drawer next October.

Regarding the evidence of the financial importance of being prepared for the transition, we need to look no further than our neighbors to the north. In Canada, when the transition took place to ICD-10, there were reports of up to a 40% disruption in cash flow caused by insufficient documentation, coding errors, and coding delays. It is being recommended that, in addition to allotting appropriate time for the transition, that each facility make certain that their cash reserves are increased to be ready for a potential disruption.

One way to reduce the amount of additional cash reserves is to make certain your facility has done everything possible to prepare for the transition. This will require time to make sure you have properly educated personnel and tested processes. Plan on at least six months for this entire preparation phase to make sure all aspects have been covered. During this process, you will want to ensure the following:

·         Create a detailed project plan that outlines specific tasks to be completed by certain people on specific dates.

·         Create a budget for staff training, possible system upgrades (anticipate a cash flow disruption beginning in October because of an increase in denials and increase in time to send out claims)

·         Educate business office staff on the details of documentation requirements, consider certification for coders

·         Communicate with software vendors to confirm their readiness for the transition

·         Create a crosswalk for your most common procedures to understand ICD code changes

·         Communicate with payers, billing company (if outsourced) and clearinghouse.

·         Work with physicians to review documentation to ensure proper detail is being recorded

·         Test communications between system and clearinghouse and payers to ensure proper data transmission

Each ASC will have its own specific issues and areas that will require unique attention, but this list highlights the areas to focus on. One more thing to remember:  Don’t worry if you’re becoming frustrated with all the commotion surrounding ICD-10… The first version ICD-11 is due out later this year.

Heidi Babb is VP for Revenue Cycle Services at Sioux Falls-based Partners Medical Consulting which provides Revenue Cycle Services, Clinical Consulting, Bookkeeping, Finance, Payroll, and Full Service Management contracts to clinics, surgery centers, and hospitals.