Despite Delay, Path to ICD-10 Continues – McKesson Homecare Talk

Posted On:
July 15th, 2014



Confused about ICD-10 implementation and what you should be doing? You’re not alone.

The one-year implementation delay to October 1, 2015, has left many healthcare organizations in a quandary over what they should be doing and when.

A scheduled session on ICD-10 implementation at this year’s McKesson Homecare & Hospice National Users’ Conference took on a new focus when the delay was announced just before the conference. Many of those who attended shared their stories of ICD-10 preparedness at their agencies. Here are some of the comments we heard:

  • One agency created a new position, a clinical care coordinator to help with coding and documentation. With salary plus training, it turned out to be quite a chunk of money.
  • Another agency spent money on training, on books, and hired a per diem coder who is certified in ICD-9 and ICD-10.
  • An agency executive said staff remain focused on the clinical side, with all monthly in-service presentations being on assessment. Doing this for the entire year should prepare the agency with the right documentation for coding. The agency spent money on books and education for managers, planning to start dual coding this summer. Those plans, however, remain up in the air.
  • Coders at one agency are doing dual coding 25% of the time, a practice that may continue despite the implementation delay.
  • One agency has been outsourcing coding for 18 months because staff coders didn’t want to learn ICD-10. It also outsources OASIS reviews. The agency’s average days in A/R is 14, where it used to be 21 days. The coding company uses McKesson, so the agency gives the coding company access to agency systems.

A recent test by CMS indicates that many providers are ready for ICD-10. A March test of 127,000 Medicare fee-for-service claims from 2,600 providers (including home health agencies) showed an 89% acceptance rate, CMS reported in June. Some regions had acceptance rates of 99%. Usual claims acceptance rates average 95%-98%.

McKesson Homecare™ and McKesson Hospice™ already feature the ability to dual code, so you can use this delay for your agency to stay on top of this important change.

To learn more about preparing for ICD-10 and how home care software can help, subscribe to our blog and like us on Facebook.

Checking in with Payers on ICD-10 Compliance | ICD-10 Online

Checking in with Payers on ICD-10 Compliance

With the ICD-10 countdown extended to October 15, 2015, providers can take advantage of the extra time to ensure they have the right tools and resources needed to achieve compliance. According to Carl Natale , editor at ICD10watch, the ICD-10 delay is the perfect time to catch up with vendors on compliance needs. His advice? Gain the time and attention of vendors now, before other medical practices are competing for their attention on ICD-10.

Key topics for your ICD-10 conversation with vendors includes discussions on testing results, reimbursement changes and information on who to contact regarding claims issues.

ICD-10 Questions for Payers

With Natale’s advice in mind, as well as the recommendations from the Centers for Medicare & Medicaid Services (CMS), below are a few questions that providers can ask payers in support of ICD-10 readiness:

  • Where is your organization in the ICD-10 preparation process?
  • What kind of testing steps are you taking?
  • What will you need from my organization in order to ensure testing readiness?
  • Do you have regular communications set up for keeping your clients up-to-date on your progress?
  • Is there a key point-of-contact within your organization for ICD-10 communications?
  • Is there an additional charge for ICD-10 systems upgrades?
  • Does your organization support dual processing?
  • What kind of customer support will be available for my organization during and after the transition?
  • Does your organization anticipate processing or payment delays, due to the transition?

With reimbursement on the line, now’s the time to ask these critical ICD-10 readiness questions of your payers.

 

Navigating ICD-10 for Healthcare Managers and Supervisors | ICD …

Navigating ICD-10 for Healthcare Managers and Supervisors

In the midst of overseeing staff, keeping budgets in line and ensuring reimbursement is met and maintaining the quality of care, health information managers and supervisors consistently have their hands full. The implementation of ICD-10 only adds a new layer of complexity. With a first line perspective on how ICD-10 will impact their staff, managers and supervisors will need to effectively navigate the concerns, questions and expectations that go hand-in-hand with the transition to ICD-10.
Advanced preparation will be key to helping your organization (and staff) smoothly transition to ICD-10. At risk are revenue and reimbursement losses from denied claims and payment delays, as well as compliance risk.
To help mitigate risk during the ICD-10 transition, critical education areas for managers and supervisors include:

  • Understanding potential systems revisions and data conversion needs
  • Clarity for reporting needs for ICD-10 compliance, including dual reporting for trending and analysis
  • Analysis of the financial impact of ICD-10, including MCCs and DRGs with the strongest impact
  • Understanding and minimizing reimbursement, revenue and budgeting challenges
  • Managing productivity and accuracy challenges
  • Minimizing the potential for increased A/R days
  • Communications to payers, vendors and clearinghouses to ensure compliance
  • Training needs for clinicians, coders and billers, helping to correct skill/knowledge deficits and gain positive engagement from staff

AHIMA recently released an article that explores additional ICD-10 transition challenges and best practice methodologies to address during the delay.

With the ICD-10 delay, now’s the time to ensure that the proper resources and educational tools are in place not only for health management professionals, but for staff that will be impacted by the transition.

Developing an ICD-10 Education Program: Essentials for Success …

Developing an ICD-10 Education Program: Essentials for Success

Between juggling rising operational costs, various reform implementation measures and tightened budgets and resources, the road to ICD-10 may be a difficult one for healthcare organizations. In addition, industry experts anticipate a 50 to 70 percent productivity loss with the transition to ICD-10.

With this in mind, now’s the time to ensure that those at the front line of ICD-10 — from nurses to coders to physicians — have the educational resources they need to make their transition to ICD-10 a success.

Meeting ICD-10 Program Needs, Gaining Staff Buy-In
To help ensure both long-term and short-term goals are met and you have staff buy in, your ICD-10 education program should:

  • Correct skill/knowledge deficits
  • Include the positive engagement of staff
  • Feature options for in-person, on-line and off-line accessibility
  • Gradually expose staff to change – ensuring awareness and detailed education is appropriate to audience
  • Mitigate current and future productivity losses
  • Support the successful implementation of ICD-10-CM/PCS with minimal disruption

First Steps: Utilizing an ICD-10 Impact Assessment
An ICD-10 impact assessment can be a great tool for helping to gage the skills of ICD-10 impacted staff, including coders, clinicians, clinical documentation improvement (CDI) specialists and nurses. Your ICD-10 impact assessment should help to:

  • Identify those affected and why (stakeholders and unique needs)
  • Pinpoint gaps in skills and knowledge
  • Gain support for allocation of resources
  • Gather baseline data to develop transitional plans

Planning and Implementing Your ICD-10 Education Program
Based on the results of your ICD-10 impact assessment, your ICD-10 education program should focus on ICD-10 basics, as well as targeting “at risk” areas (including MS-DRGs and productivity codes) that stand to have a strong financial impact on your organization. The right budgeting and resources should be allocated (with outsourcing as a possible consideration) for your program’s success.

To improve the effectiveness of the program, your ICD-10 education platform should be flexible and accessible, including on-site and off-site availability for participants to access course material, and also be customized for the audience. For example, consider creating separate, customized ICD-10 programs for your coders, physicians and non-clinical departments (human resources, patient financial services, etc.).

Measurement and Milestone Activities
To help ensure that your ICD-10 education program is on the right track, be sure to set milestones for action items and compliance needs, including:

  • Measuring coding accuracy and productivity, and their impact on reimbursement, including:
    • Case Mix Index Reimbursement
    • MS-DRGs with and without MCCs/CCs
    • Top 50 procedures
    • Productivity rates/accuracy rates
    • Physician query outcomes and changes to payments
  • Performing parallel reporting and comparison of historical data
    • Monitoring documentation improvement and effects of data use, e.g. patient outcomes
    • Using management reporting to confirm that educational efforts are effective

ICD-10: The Right Information at the Right Time for the Right People
Overall considerations to keep in mind when developing your ICD-10 education program:

  • Plan for the future, not just up to the implementation date
    • Determine baseline skill sets
    • Identify core deficiencies
  • Evaluate needs two years past implementation
  • Identify skill set similarities and differences among staff, including:
    • Across and within job functions
  • Determine where positions will be redefined:
    • Is there a need for cross-training?

With these best practices in your mind, your customized ICD-10 education program can gain the support needed to help meet regulatory compliance, mitigate revenue gaps and productivity loss, and improve the patient care experience.

Weighing the Pros and Cons of the Latest ICD-10 Delay | ICD-10 …

Weighing the Pros and Cons of the Latest ICD-10 Delay

The reviews are decidedly mixed on the latest ICD-10 delay. The healthcare industry has spent considerable time and money on ICD-10 readiness. Is the anticipation of a “final” date, followed by another round of delays, taking its toll? Below, we examine a few pros and cons of the 2014 delay.

Pros

Additional time for documentation improvement and coder practice. Practice, practice, practice is key. The ICD-10 delay will allow healthcare providers additional time to evaluate their clinical documentation improvement and coder programs. By taking a deeper dive into targeting the highest risk areas, providers can reduce compliance risk while decreasing potential gaps in the revenue cycle and reimbursement.

Re-evaluation of education/training program and communications: Did you underestimate the time and amount of training your ICD-10 impacted staff would need? Now’s the time to go back and assess your ICD-10 education/training program, and evaluate which curriculum and ICD-10 impacted staff may need more attention.

The additional delay time can also help providers improve their communications and awareness plan for ICD-10 education/training, ensuring that the right messaging is reaching the intended audience through newsletters, staff briefings and other channels.

A wider testing window. With the additional delay, providers will have a renewed timeline to upgrade and test their health IT systems. Do you need additional support for your ICD-10 technology team? Have the necessary systems been evaluated for potential upgrades and replacement? Have the right vendor contacts been made? These are all questions that should be asked as part of your ICD-10 checklist.

Cons

Continued use of the outdated ICD-9 code set. With its lack of detailed diagnoses and procedure codes, ICD-9 continues will continue to linger in the healthcare industry as yet another ICD-10 delay as been instituted. As the only developed country not using ICD-10, the U.S. puts at risk its ability to improve quality measures and patient care with the delay.

Money, money, money. The expense of ICD-10 readiness has been substantial for providers, adding to already limited resources due to meaningful use, increasing costs and other regulatory changes. Money that went into the 2014 ICD-10 implementation deadline, including costs for additional systems, resources and upgrades, could potentially have been spent on other areas of need for healthcare systems.

Is this really the final deadline change? Now that ICD-10 has been delayed yet again, healthcare industry, from C-level to nurses and physicians, may have difficulty in taking the new initiative deadline seriously (who’s to say another delay isn’t right around the corner?)

What’s your take on the latest ICD-10 delay?