The recent proposal to delay the implementation of ICD-10 by one full year has received a mixed response from healthcare organizations. Many hospitals and medical practices that had started working on the transition (and were making progress) are frustrated by the delay. They fear it may halt momentum and slow forward movement. Conversely, many of those organizations that had not begun work are relieved by the date change—and glad they had not started preparation efforts in earnest.

Regardless of whether your practice is frustrated or relieved by the delay, the implications will be the same: You should anticipate some changes to your implementation plan. While the steps involved in completing the ICD-10 transition project will remain the same— for example, assessing your practice’s current ICD-9 use, mapping codes, upgrading software, educating physicians and staff, and testing—the deadlines for these efforts will change. Practices need to review and re-evaluate both internal deadlines and external ones, such as those agreed upon by vendors and payers.

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Although the ICD-10 implementation date is expected to be delayed, it is still critical that practices start preparing for the transition now. In this free webinar sponsored by Navicure, learn how practices can shift their focus from 5010 to ICD-10 and how planning ahead will assist with a smooth and successful transition.

Join us on Thursday, May 17^th at 1:00 pm EDT for the webinar, ICD-10: Evaluating the Impact on Your Revenue Cycle. Register Now.

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This past Monday, the Department of Health and Human Services (HHS) proposed that the ICD-10 implementation deadline be extended one full year to October 1, 2014, as opposed to the original October 1, 2013 deadline.

Multiple provider groups had expressed concerns to HHS about meeting the original compliance deadline for ICD-10. The extra year would give these providers and other covered entities more time to test and prepare their systems to help ensure a smoother transition.

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Over the last few months, there seems to have been an endless string of stories focused on the how ICD-10 will change the entire industry – specifically how clinicians will be impacted. While the clinical side will need to ensure more detailed documentation occurs, the business side of healthcare will also have to adjust their workflow and habits for the new code set.

To have a successful ICD-10 implementation, practices are going to have to understand key operational revenue cycle metrics and what they mean to the practice’s bottom line. Here are some suggestions to help manage the business side of ICD-10:

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As practices begin working on the transition to ICD-10, more and more questions are emerging every day. Here’s a look at four Frequently Asked Questions (FAQs), with answers to help you prepare:

FAQ: What is the difference between ICD-10-PCS codes and ICD-10-CM codes?

ICD-10-CM codes are diagnosis codes. They are defined globally by the World Health Organization (WHO), but are modified for use in the United States by the National Center for Health Statistics (NCHS). Most professional, outpatient and ambulatory practices will use ICD-10-CM codes.

By contrast, ICD-10-PCS codes are procedure codes. These codes are created by the Centers for Medicare and Medicaid Services (CMS) and are only used on inpatient, facility-based claims. Ambulatory practices will continue to use CPT procedure codes, just as they do now, when ICD-10 takes effect.

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The month of January presents opportunities to not only consider the year ahead, but also look back at the year just passed. With this in mind, we wanted to take a look at our most popular blogs from 2011. As you’ll see, most of them merit revisiting as your practice plans for the future.

• HIPAA 5010 – Understanding Two Important New Requirements. This blog focuses on two changes medical practices must make to their claims submission process to be 5010 compliant: using a physical address as the provider billing address and incorporating nine-digit ZIP codes into billing provider and service facility addresses. While many practices have made these changes, we’re finding that some still need to do so. It’s important to note that technology vendors cannot make these changes for practices; practices must make them on their own.

• How Paper Claims Will Be Impacted by 5010. This blog clears up some confusion that still exists today about how 5010 affects paper-based claims. While most providers filing claims with Medicare and other payers need to be compliant with 5010, those providers or payers who meet certain exceptions to the HIPAA requirements and still file on paper aren’t subject to 5010 requirements. If you’re among those providers, you can continue filing paper claims as always—at least for now.

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As an industry, the transition to HIPAA 5010 has been a learning opportunity – especially showing the benefits of planning and questioning a vendor’s capabilities early on. These lessons can be taken and applied to the next big transition – ICD-10, which will be the required coding set starting on October 1, 2013. Many people in the industry believe that there is plenty of time before the transition, and that they can start the transition process at a later time. However, now is the time for practices to start preparing for the coding change. So when I was recently given the opportunity to speak with a writer from For the Record about how the transition to ICD-10 would impact the industry and how practices should prepare, I was happy to share my thoughts.

At the start of this conversation, we focused on how this transition would impact everyone in the healthcare industry. It was the coders, though, that quickly became the focal point of our discussion. Specifically, we talked about the types of questions coders should be asking when preparing an ICD-10 transition plan. These questions include:

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Thank you to everyone who joined us on December 6 for our latest webinar, 5010 and ICD-10 – What You Must Know Now. During the one-hour event, industry expert, Ken Bradley, Vice President of Strategic Planning at Navicure, discussed where the industry is and where your practice should be with regards to 5010 and ICD-10; what to do if you have not begun preparing for 5010; how to fix the biggest problems practices are having with the 5010 requirements; and what steps you can take for ICD-10 revenue management success.

To learn more about how you can prepare for these two transitions, click here  to download the webinar recording.

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The HIPAA 5010 transition deadline is January 1, 2012. Is your practice prepared? If not, your bottom line will suffer.

Time is running out, but if you take the proper steps now, you can be ready. Since 5010 enables ICD-10, come January 1, the industry will have completed its first step towards ICD-10 compliance. However, ICD-10 will have a much bigger impact than 5010 and will require providers to re-think all processes. Practices must be preparing for ICD-10 now.

Join us on Tuesday, December 6 at 1:00 pm EST, for a free webinar: 5010 and ICD-10 – What You Must Know Now. Register Now.

During this hour, you’ll hear industry expert, Ken Bradley, Vice President of Strategic Planning at Navicure, discuss:

• Where the industry is and where your practice should be with regards to 5010 and ICD-10
• What to do if you have not begun preparing for 5010
• How to fix the biggest problems practices are having with the 5010 requirements
• What steps you can take for ICD-10 revenue management success

Make sure that your practice is prepared for these transitions.

 Participants can earn 1.0 Continuing Education Unit (CEU) from the American Academy of Professional Coders (AAPC) by attending.

Register Now.

Last week, I had the pleasure of attending the Medical Group Management Association’s annual meeting in Las Vegas. During the conference, I was excited to speak with other practice managers, physicians and technology vendors about the constant changes in the medical field – including how people handle ongoing issues such as denials management and revenue cycle management.

In addition to these insightful conversations, I had the honor of leading an educational session about preparing for the pending 5010 and ICD-10 transitions. During the hour, I provided tips about how every practice can prepare for the implementation of both 5010 and ICD-10, especially focusing on how practices can ensure that they have mitigated the possibility of revenue cycle disruptions during the transitions. During the session, there were many great questions and I was happy to see people starting to think about the transition to ICD-10. In addition, Healthcare Finance News wrote a quick synopsis of the session, which you can read here.

I look forward to hearing how people take these recommendations and apply them to their own practice. As your organization works towards both implementation deadlines, let everyone know how it is going by adding a comment in the boxes below.